Provider Demographics
NPI:1174827182
Name:LINDELL, GERALDINE ZETTA (LMT)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:ZETTA
Last Name:LINDELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:GERALDINE
Other - Middle Name:ZETTA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:21114 SECRETARIAT RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7557
Mailing Address - Country:US
Mailing Address - Phone:512-657-0787
Mailing Address - Fax:
Practice Address - Street 1:21114 SECRETARIAT RIDGE LN
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7557
Practice Address - Country:US
Practice Address - Phone:512-657-0787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT015912225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist