Provider Demographics
NPI:1750032280
Name:BURNETT, LINDSEY LEIGH (DC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LEIGH
Last Name:BURNETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 BAYTREE BND
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2919
Mailing Address - Country:US
Mailing Address - Phone:940-390-1412
Mailing Address - Fax:
Practice Address - Street 1:501 TROPHY LAKE DR STE 322
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5239
Practice Address - Country:US
Practice Address - Phone:817-430-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor