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Individual

LYDIA F. OWEN-WYATT

Active
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Individual

LYDIA F. OWEN-WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00528
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
060359902
TX
05
060359903
TX
05
060359904
TX
05
060359905
TX
05
060359906
TX
05
060359907
TX
01
8N4424
BLUE CROSS BLUE SHIELD
TX
01
P00049546
RAILROAD MEDICARE
Enumeration date
11/29/2005
Last updated
09/03/2009
About Stedi
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