Provider Demographics
NPI:1285324731
Name:LYRAD HEALTH, PLLC
Entity type:Organization
Organization Name:LYRAD HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-819-8206
Mailing Address - Street 1:PO BOX 530612
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75053-0612
Mailing Address - Country:US
Mailing Address - Phone:972-639-3992
Mailing Address - Fax:833-628-6624
Practice Address - Street 1:2701 OSLER DR STE 2
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8386
Practice Address - Country:US
Practice Address - Phone:972-639-3992
Practice Address - Fax:833-628-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty