Provider Demographics
NPI:1639177181
Name:LLOYD, JESSICA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:CHILDREN'S MEDICAL CENTER DALLAS - HOSPITALIST DIVISION
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-5743
Mailing Address - Fax:214-456-4486
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:CHILDREN'S MEDICAL CENTER DALLAS - HOSPITALIST DIVISION
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-5743
Practice Address - Fax:214-456-4486
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM88012080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1924164Medicaid
LA5N601Medicare ID - Type Unspecified
LA1924164Medicaid