Provider Demographics
NPI:1760419576
Name:LYONS, MICHAEL DARIN (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DARIN
Last Name:LYONS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0520
Mailing Address - Country:US
Mailing Address - Phone:325-643-3300
Mailing Address - Fax:325-641-8714
Practice Address - Street 1:109 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5917
Practice Address - Country:US
Practice Address - Phone:325-643-3300
Practice Address - Fax:325-641-8714
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0389207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092500004Medicaid
TX8327N1Medicare ID - Type Unspecified