Provider Demographics
NPI:1407293137
Name:SAGAR, LYDIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:SAGAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CENTRAL DR STE 160
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5823
Mailing Address - Country:US
Mailing Address - Phone:682-289-0546
Mailing Address - Fax:855-658-1426
Practice Address - Street 1:1901 CENTRAL DR STE 160
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5823
Practice Address - Country:US
Practice Address - Phone:682-289-0546
Practice Address - Fax:855-658-1426
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36413103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling