Provider Demographics
NPI:1235551128
Name:PATE, LINDSAY (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:PATE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 12TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2518
Mailing Address - Country:US
Mailing Address - Phone:817-877-1118
Mailing Address - Fax:817-877-5317
Practice Address - Street 1:800 12TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2518
Practice Address - Country:US
Practice Address - Phone:817-877-1118
Practice Address - Fax:817-877-5317
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08587363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant