Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | P4344 | TX |
NPI | 1053577882 |
---|---|
Provider Name | Dr. Jamie Lynn Lynch |
First Address | San Antonio, TX 78265-9506 |
Second Address | San Antonio, TX 78258-4218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 19/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8KJ487 | BCBS (01) | TX |