Basic Information
| Provider Information | |||||||||
| NPI: | 1174816748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPRINGFIELD | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | ATP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 COUNTY ROAD 389 | ||||||||
| Address2: | |||||||||
| City: | GRANGER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765305310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128592513 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6807 WOODWAY DR | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767126146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2543990444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2011 | ||||||||
| LastUpdateDate: | 05/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.