Provider Demographics
NPI:1922732262
Name:LYONS, MATTHEW DOUGLAS (OD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DOUGLAS
Last Name:LYONS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 STACY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8721
Mailing Address - Country:US
Mailing Address - Phone:214-383-5400
Mailing Address - Fax:214-383-5203
Practice Address - Street 1:1546 STACY RD STE 100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8721
Practice Address - Country:US
Practice Address - Phone:214-383-5400
Practice Address - Fax:214-383-5203
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10655T152W00000X
TX10655TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist