Provider Demographics
NPI:1700447844
Name:MYRON S LAZAR PHD
Entity Type:Organization
Organization Name:MYRON S LAZAR PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-979-2779
Mailing Address - Street 1:8330 MEADOW RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3765
Mailing Address - Country:US
Mailing Address - Phone:972-979-2779
Mailing Address - Fax:214-360-4796
Practice Address - Street 1:8330 MEADOW RD STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3765
Practice Address - Country:US
Practice Address - Phone:972-979-2779
Practice Address - Fax:214-360-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Single Specialty