Provider Demographics
NPI:1861635641
Name:DWUMA, LYDIA A (RN, HP (ASCP))
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:A
Last Name:DWUMA
Suffix:
Gender:F
Credentials:RN, HP (ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15195 SHELLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6493
Mailing Address - Country:US
Mailing Address - Phone:469-252-4832
Mailing Address - Fax:972-369-0673
Practice Address - Street 1:15195 SHELLWOOD LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6493
Practice Address - Country:US
Practice Address - Phone:469-252-4832
Practice Address - Fax:972-369-0673
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012058251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health