Provider Demographics
NPI:1790880979
Name:LINDSEY, TERRY M (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:M
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78292-0437
Mailing Address - Country:US
Mailing Address - Phone:830-774-2505
Mailing Address - Fax:830-774-2394
Practice Address - Street 1:1200 N BEDELL AVE
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840
Practice Address - Country:US
Practice Address - Phone:830-774-2505
Practice Address - Fax:830-774-2394
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7154207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114241603Medicaid
TXTXB130280Medicare PIN
TXC18451Medicare UPIN
TX83V692Medicare ID - Type Unspecified