Provider Demographics
NPI:1770658163
Name:LINDAHL, YVONNE MICHELLE (PA C)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:MICHELLE
Last Name:LINDAHL
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2917
Mailing Address - Country:US
Mailing Address - Phone:214-642-0652
Mailing Address - Fax:
Practice Address - Street 1:3500 OAK LAWN
Practice Address - Street 2:STE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4308
Practice Address - Country:US
Practice Address - Phone:214-520-8833
Practice Address - Fax:214-520-2956
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04036363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant