Provider Demographics
NPI:1679182653
Name:BOYER, LINDSAY PAIGE
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:PAIGE
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12717 INTERSTATE 45 N STE 300
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-7035
Mailing Address - Country:US
Mailing Address - Phone:936-228-7598
Mailing Address - Fax:
Practice Address - Street 1:12717 INTERSTATE 45 N STE 300
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-7035
Practice Address - Country:US
Practice Address - Phone:936-228-7598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX919514163WE0003X
TX1019214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency