Provider Demographics
NPI:1366485369
Name:SMITH, LINDSAY L (PA)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:508 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 350
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2845
Mailing Address - Country:US
Mailing Address - Phone:936-760-9900
Mailing Address - Fax:936-760-9926
Practice Address - Street 1:4015 INTERSTATE 45 N
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4901
Practice Address - Country:US
Practice Address - Phone:936-522-4918
Practice Address - Fax:936-522-4921
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03827363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180339701Medicaid
TX180339701Medicaid
GAP00345020Medicare PIN
TX8B5858Medicare PIN