Provider Demographics
NPI:1306071402
Name:LYSSY, ANTHONY LEE (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LEE
Last Name:LYSSY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5950 BERKSHIRE LN STE 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5857
Mailing Address - Country:US
Mailing Address - Phone:214-550-2090
Mailing Address - Fax:888-502-1190
Practice Address - Street 1:5950 BERKSHIRE LN STE 225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5857
Practice Address - Country:US
Practice Address - Phone:214-550-2090
Practice Address - Fax:888-502-1190
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine