Provider Demographics
NPI:1083822431
Name:LYNCH, JIM S JR (RCIS,RCVT)
Entity Type:Individual
Prefix:MR
First Name:JIM
Middle Name:S
Last Name:LYNCH
Suffix:JR
Gender:M
Credentials:RCIS,RCVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 WOODED TRL
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-7189
Mailing Address - Country:US
Mailing Address - Phone:903-399-2505
Mailing Address - Fax:
Practice Address - Street 1:168 WOODED TRL
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7189
Practice Address - Country:US
Practice Address - Phone:903-399-2505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularCardiovascular Invasive Specialist