Provider Demographics
NPI:1134693963
Name:LINDSAY AND MAGRUDER ORTHODONTICS
Entity Type:Organization
Organization Name:LINDSAY AND MAGRUDER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAGRUDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-486-1018
Mailing Address - Street 1:1616 CLEAR LAKE CITY BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8069
Mailing Address - Country:US
Mailing Address - Phone:281-486-1018
Mailing Address - Fax:281-486-1075
Practice Address - Street 1:1616 CLEAR LAKE CITY BLVD STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-8069
Practice Address - Country:US
Practice Address - Phone:281-486-1018
Practice Address - Fax:281-486-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1215453212OtherNPPES
TX1003916503OtherNPPES