Provider Demographics
NPI:1134471626
Name:SWEATT, LINDSEY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:SWEATT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:WAITES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1601 E DEBBIE LN
Mailing Address - Street 2:SUITE 2109
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3674
Mailing Address - Country:US
Mailing Address - Phone:817-473-9125
Mailing Address - Fax:817-473-9126
Practice Address - Street 1:1601 E DEBBIE LN
Practice Address - Street 2:SUITE 2109
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3674
Practice Address - Country:US
Practice Address - Phone:817-473-9125
Practice Address - Fax:817-473-9126
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08024363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant