Doctor Name: | EBONY LINDSEY |
NPI Number: | 1306211909 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | AP129517 |
Business Practice Address: | 2800 E Highway 114 Ste 200 Trophy Club, TX - 762625306 |
Business Phone Number: | 8175433300 |
Business Fax Number: | 8175433309 |
Mailing Address: | 2800 E Highway 114 Ste 200, TROPHY CLUB |
State: | TX |
Postal Code: | 762625306 |
Phone Number: | 8175433300 |
Fax Number: | 8175433309 |
NPI Enumeration Date: | 12/08/2015 |
NPI Last Update Date: | 01/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | AP129517 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |