Provider Demographics
NPI:1821265497
Name:JAMES MICHAEL LLOYD
Entity Type:Organization
Organization Name:JAMES MICHAEL LLOYD
Other - Org Name:J. MICHAEL LLOYD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MSD
Authorized Official - Phone:817-483-2445
Mailing Address - Street 1:3851 SW GREEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4130
Mailing Address - Country:US
Mailing Address - Phone:817-483-2445
Mailing Address - Fax:817-483-2677
Practice Address - Street 1:3851 SW GREEN OAKS BLVD
Practice Address - Street 2:123
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4130
Practice Address - Country:US
Practice Address - Phone:817-483-2445
Practice Address - Fax:817-483-2677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13549302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1356456602OtherNPI-TYPE I