Provider Demographics
NPI:1598409534
Name:FRITTS, LYNSEY ABBOTT (DPT)
Entity Type:Individual
Prefix:DR
First Name:LYNSEY
Middle Name:ABBOTT
Last Name:FRITTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 MANGUM ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-3515
Mailing Address - Country:US
Mailing Address - Phone:903-886-7669
Mailing Address - Fax:903-886-7679
Practice Address - Street 1:2544 MANGUM ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3515
Practice Address - Country:US
Practice Address - Phone:903-886-7669
Practice Address - Fax:903-886-7679
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1343211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141625702Medicaid
TX1598409534OtherBLUE CROSS BLUE SHIELD OF TEXAS