Bundick, Lydia

Bundick, Lydia is an individual health care provider with primary practice located at 2929 Calder St Suite 100, Beaumont TX 77702-1845. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Bundick, Lydia can be contacted via phone (409) 833-9797.

Contact Information

Primary practice address
2929 Calder St Suite 100 Beaumont TX 77702-1845
Phone: (409) 833-9797
Fax: (409) 654-6921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 804089 Texas
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP133119 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP133119 Texas

Profile Details

NPI number 1316483092
LBN Legal business name Bundick, Lydia
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2017
Last updated Sep 11th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316483092 NPPES
Texas MEDICAID 368262701

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