Provider Demographics
NPI:1003081118
Name:LINGRAY ENTERPRISES LLC
Entity Type:Organization
Organization Name:LINGRAY ENTERPRISES LLC
Other - Org Name:LADIES CHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:GAYE
Authorized Official - Last Name:HENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-870-9194
Mailing Address - Street 1:900 HEMPHILL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3170
Mailing Address - Country:US
Mailing Address - Phone:817-870-9194
Mailing Address - Fax:817-870-1473
Practice Address - Street 1:900 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3170
Practice Address - Country:US
Practice Address - Phone:817-870-9194
Practice Address - Fax:817-870-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6188820001Medicare NSC