Basic Information
| Provider Information | |||||||||
| NPI: | 1730140906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDZEY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 844658 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752844658 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 W HIGHWAY 71 | ||||||||
| Address2: | |||||||||
| City: | MARBLE FALLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786548606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302017100 | ||||||||
| FaxNumber: | 8302017304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2006 | ||||||||
| LastUpdateDate: | 01/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G8245 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | TIN PLUS 042 | 01 | TX | TRICARE | OTHER | 1342347-06 | 05 | TX | MEDICAID | P01054635 | 01 | TX | MEDICARE RR | OTHER | 8DE643 | 01 | TX | BCBS | OTHER | TIN PLUS 042 | 01 | TX | TRICARE TC | OTHER | 110211247 | 01 | TX | RR/MEDICARE | OTHER | 1342347-05 | 01 | TX | CSHCN | OTHER | 134234710 | 05 | TX | MEDICAID | 8BC263 | 01 | TX | BCBS BILLING NUMBER ONLY | OTHER | P00739414 | 01 | TX | MCRR JV | OTHER | TIN PLUS 005 | 01 | TX | TRICARE JV | OTHER | 134234709 | 05 | TX | MEDICAID | 1730140906 | 01 | TX | BCBS JV LOCATION | OTHER | 807659 | 01 | TX | BLUE SHIELD | OTHER | 134234708 | 05 | TX | MEDICAID |