Provider Demographics
NPI:1336376052
Name:LYONS, THOMAS F JR (RM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:LYONS
Suffix:JR
Gender:M
Credentials:RM
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 1814
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1059
Mailing Address - Country:US
Mailing Address - Phone:323-325-8681
Mailing Address - Fax:206-350-2150
Practice Address - Street 1:307 SAN VICENTE CIR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2152
Practice Address - Country:US
Practice Address - Phone:323-325-8681
Practice Address - Fax:206-350-2150
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist