Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | M0798 | TX |
Y | 208600000X | Surgeon | M0798 | TX |
NPI | 1003848789 |
---|---|
Provider Name | Mark Raymond Lindsey |
First Address | Austin, TX 78756-4027 |
Second Address | Austin, TX 78756-4027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 27/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0043AK | MEDICARE P-TIN (01) | TX |
176301302 | (05) | TX |
I34770 | (02) | TX |