Provider Demographics
NPI:1043297849
Name:BARRY, LYNDA J (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:J
Last Name:BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9821 CHINA SPRING RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-4800
Mailing Address - Country:US
Mailing Address - Phone:254-202-7400
Mailing Address - Fax:254-202-7450
Practice Address - Street 1:9821 CHINA SPRING RD
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-4800
Practice Address - Country:US
Practice Address - Phone:254-202-7400
Practice Address - Fax:254-202-7450
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L20612Medicare PIN