Provider Demographics
NPI:1265638233
Name:LINDENFELD, MAURA B (PNP)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:B
Last Name:LINDENFELD
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1401 W PULASKI ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2717
Practice Address - Country:US
Practice Address - Phone:682-885-8012
Practice Address - Fax:682-885-8014
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX698575363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205664001Medicaid
TX205664004OtherCSHCN
TX137283112OtherMEDICAID GROUP NUMBER
TX205664003Medicaid
TX00L42VOtherMEDICARE GROUP NUMBER
TX150220509OtherCSHCN GROUP NUMBER
TX150220508OtherMEDICAID GROUP NUMBER
TX00257TOtherMEDICARE GROUP NUMBER
TX137283113OtherCSHCN GROUP NUMBER
TX205664002OtherCSHCN
TX150220508OtherMEDICAID GROUP NUMBER
TX00257TOtherMEDICARE GROUP NUMBER