Provider Demographics
NPI:1497288518
Name:LIN, BILLIKEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLIKEN
Middle Name:T
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 VIRGINIA SQ
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4948
Mailing Address - Country:US
Mailing Address - Phone:817-888-1276
Mailing Address - Fax:
Practice Address - Street 1:6515 VIRGINIA SQ
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4948
Practice Address - Country:US
Practice Address - Phone:817-888-1276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine