Provider Demographics
NPI:1376133884
Name:LINDLEY, DIRK BRYCE (DC)
Entity Type:Individual
Prefix:DR
First Name:DIRK
Middle Name:BRYCE
Last Name:LINDLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 OLD MCGREGOR RD # 2A
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3600
Mailing Address - Country:US
Mailing Address - Phone:254-537-1064
Mailing Address - Fax:254-537-1092
Practice Address - Street 1:8300 OLD MCGREGOR RD # 2A
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3600
Practice Address - Country:US
Practice Address - Phone:254-537-1064
Practice Address - Fax:254-537-1092
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor