Provider Demographics
NPI:1245395110
Name:TAMEZ, LINDSAY M (OTR)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:M
Last Name:TAMEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15316 HUEBNER RD STE 202
Mailing Address - Street 2:P O BOX 3846
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-0994
Mailing Address - Country:US
Mailing Address - Phone:210-614-4567
Mailing Address - Fax:210-614-4999
Practice Address - Street 1:15316 HUEBNER RD STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-0994
Practice Address - Country:US
Practice Address - Phone:210-614-4567
Practice Address - Fax:210-614-4999
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110663225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165413901Medicaid