Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1048601 | TX |
NPI | 1114086154 |
---|---|
Provider Name | Ms. Brenda J. Lindsay |
First Address | Mcallen, TX 78504-2365 |
Second Address | Mcallen, TX 78504-2365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 24/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
143404501 | (05) | TX |
742629110 | (05) | TX |
742965954 | FACILITY TAX ID NO. (01) | TX |