Provider Demographics
NPI:1871603522
Name:EGER, LYNNE M (MD)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:M
Last Name:EGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-1485
Practice Address - Fax:817-338-1841
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK72792080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106023807OtherCSHCN
TX1727199OtherFIRSTHEALTH PIN
TX492709OtherPRONET PIN
TX106023806Medicaid
TX88V633OtherBCBSTX IND PIN
TX112158100OtherFIRSTCARE PIN
TX1279052OtherUHC PIN
TX00U87ZOtherBCBSTX GRP PIN
TX3102295OtherCIGNA PIN
TX10024561OtherAMERIGROUP PIN
TX124133OtherSUPERIOR PIN
1750369203OtherGRP NPI NUMBER
TX4624199OtherAETNA PIN
TX9054210OtherPHCS PIN
TX4624199OtherAETNA PIN
TX00U87ZOtherBCBSTX GRP PIN