Provider Demographics
NPI:1114086154
Name:LINDSAY, BRENDA J (BS, PT)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:J
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:BS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E YUCCA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2365
Mailing Address - Country:US
Mailing Address - Phone:956-630-6365
Mailing Address - Fax:956-630-6365
Practice Address - Street 1:516 E YUCCA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2365
Practice Address - Country:US
Practice Address - Phone:956-630-6365
Practice Address - Fax:956-630-6365
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10486012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742965954OtherFACILITY TAX ID NO.
TX143404501Medicaid
TX742629110Medicaid
TX143404501Medicaid