Provider Demographics
NPI:1427719145
Name:FYDA, KAREN (EFDA)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:FYDA
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7718
Mailing Address - Country:US
Mailing Address - Phone:210-808-3537
Mailing Address - Fax:
Practice Address - Street 1:3711 JOHN ALDEN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3203
Practice Address - Country:US
Practice Address - Phone:210-323-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist