Provider Demographics
NPI:1225018286
Name:ESSARY, LYDIA R (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:R
Last Name:ESSARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 N STONEBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7437
Mailing Address - Country:US
Mailing Address - Phone:972-390-9002
Mailing Address - Fax:214-491-3777
Practice Address - Street 1:1790 N STONEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7437
Practice Address - Country:US
Practice Address - Phone:972-390-9002
Practice Address - Fax:214-491-3777
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8136207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010193700Medicaid
TX8C0135Medicare ID - Type Unspecified
FLHQ215ZMedicare PIN
FL010193700Medicaid
TXH07723Medicare UPIN