Provider Demographics
NPI:1861955502
Name:LI, LUCY (MD)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COIT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6171
Mailing Address - Country:US
Mailing Address - Phone:972-596-2470
Mailing Address - Fax:972-596-6526
Practice Address - Street 1:1600 COIT RD STE 202
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6171
Practice Address - Country:US
Practice Address - Phone:972-596-2470
Practice Address - Fax:972-596-6526
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6007207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty