Provider Demographics
NPI:1558712281
Name:SHEPHERD, LINDSEY (DAT, LAT, ATC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:DAT, LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5705
Mailing Address - Country:US
Mailing Address - Phone:210-671-9141
Mailing Address - Fax:
Practice Address - Street 1:1170 EAGLE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78236-5705
Practice Address - Country:US
Practice Address - Phone:210-671-9141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960032822255A2300X
AZ0010422255A2300X
MO20170111262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer