Individual
LIDA LACY EDMUNDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12700 HILLCREST RD, SUITE 260, DALLAS, TX 75230-2033
(972) 789-9319
(972) 789-9324
Mailing address
12700 HILLCREST RD, SUITE 260, DALLAS, TX 75230-2033
(972) 789-9319
(972) 789-9324
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D3210
TX
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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