Provider Demographics
NPI:1316550775
Name:HACKLER, LYNSEY NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYNSEY
Middle Name:NICOLE
Last Name:HACKLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LYNSEY
Other - Middle Name:NICOLE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9740 BARKER CYPRESS RD STE 113
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1975
Mailing Address - Country:US
Mailing Address - Phone:832-220-4300
Mailing Address - Fax:
Practice Address - Street 1:9740 BARKER CYPRESS RD STE 113
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1975
Practice Address - Country:US
Practice Address - Phone:281-502-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36617122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty