Carolyn B Lyde MD PA

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

H0585 Issued in TX

Legal business name

CAROLYN B LYDE MD PA

Practice address

324 W Main Street
Suite 200
Lewisville, TX 75057-3641

Phone

(972) 436-0358

Fax

(972) 353-3750

NPI assigned

May 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carolyn B Lyde, M.D.

Title

Owner

Phone

(972) 436-0358

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280102400000",
    "number": "1659328870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W MAIN STREET",
            "address_2": "SUITE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573641",
            "telephone_number": "972-436-0358",
            "fax_number": "972-353-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W MAIN STREET",
            "address_2": "SUITE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573641",
            "telephone_number": "972-436-0358",
            "fax_number": "972-353-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN B LYDE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-07-26",
        "status": "A",
        "authorized_official_last_name": "LYDE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-436-0358",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TX",
            "license": "H0585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Lewisville, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.