Provider Demographics
NPI:1285638973
Name:THOMAS, LINDY (PA)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PA
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 1310
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373-1310
Mailing Address - Country:US
Mailing Address - Phone:806-998-4533
Mailing Address - Fax:806-810-1560
Practice Address - Street 1:1809 LOCKWOOD ST
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373
Practice Address - Country:US
Practice Address - Phone:806-998-4604
Practice Address - Fax:806-810-1560
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00732363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00240Medicare UPIN