Individual
LYUDMYLA LYSENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(817) 451-4208
(817) 563-3699
Mailing address
6300 RIDGLEA PL, SUITE 201, FORT WORTH, TX 76116-5704
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT189495
PA
Other
Enumeration date
05/03/2007
Last updated
04/28/2017
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