Provider Demographics
NPI:1710993605
Name:SPEAKS, LYNN MARIE (DO)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:SPEAKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2908
Mailing Address - Country:US
Mailing Address - Phone:817-238-0109
Mailing Address - Fax:817-238-0647
Practice Address - Street 1:3914 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2908
Practice Address - Country:US
Practice Address - Phone:817-238-0109
Practice Address - Fax:817-238-0647
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7906207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B5591OtherBCBS
TX151363201Medicaid
TX151363203Medicaid
TX151363203Medicaid
TX160057804OtherRAILROAD MEDICARE PIN
TX151363203Medicaid
TX8782B6Medicare PIN