Provider Demographics
NPI:1992113518
Name:ROYAL, LILLIAN (DVM)
Entity type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:
Last Name:ROYAL
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3844
Mailing Address - Country:US
Mailing Address - Phone:336-667-1109
Mailing Address - Fax:336-667-5858
Practice Address - Street 1:1007 2ND ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3844
Practice Address - Country:US
Practice Address - Phone:336-667-1109
Practice Address - Fax:336-667-5858
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5964174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5964OtherNCVMB
NCBR 9783728OtherDEA