Basic Information
| Provider Information | |||||||||
| NPI: | 1326087495 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDSAY | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | JOAN | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 732915 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753732915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037181616 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8200 WALNUT HILL LN | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752314426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143457456 | ||||||||
| FaxNumber: | 2143454152 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 08/26/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 731298 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 731298 | 01 | TX | LICENSE | OTHER |