Provider Demographics
NPI:1386672152
Name:LIACI, JULIA A (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:LIACI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:317 CENTRAL EXPY N STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2631
Mailing Address - Country:US
Mailing Address - Phone:214-271-4600
Mailing Address - Fax:214-271-4604
Practice Address - Street 1:1105 CENTRAL EXPY N
Practice Address - Street 2:SUITE 2310
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6103
Practice Address - Country:US
Practice Address - Phone:214-271-4600
Practice Address - Fax:214-271-4604
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8111207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165596106Medicaid
I08994Medicare UPIN