Provider Demographics
NPI:1487894937
Name:LYONS, DANIELLE (PA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:469-291-3372
Mailing Address - Fax:214-648-8423
Practice Address - Street 1:6201 HARRY HINES BLVD.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9213
Practice Address - Country:US
Practice Address - Phone:214-648-3916
Practice Address - Fax:214-648-8423
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10590363A00000X
MAPA4669363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical