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Individual

LYDIA C. SECOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-8383
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
529840
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
196900801
TX
05
196900803
TX
05
196900804
TX
05
196900805
TX
05
196900806
TX
05
196900807
TX
05
196900808
TX
05
196900809
TX
05
196900810
TX
01
8Y1695
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/29/2007
Last updated
03/06/2009
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