Provider Demographics
NPI:1942606694
Name:HEAD, LYNDA ELIZABETH (RT, RDMS, RVS)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:ELIZABETH
Last Name:HEAD
Suffix:
Gender:F
Credentials:RT, RDMS, RVS
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:ELIZABETH
Other - Last Name:LAURIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RT, RDMS, RVS
Mailing Address - Street 1:550 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-3820
Mailing Address - Country:US
Mailing Address - Phone:918-588-1900
Mailing Address - Fax:918-582-6405
Practice Address - Street 1:550 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-3820
Practice Address - Country:US
Practice Address - Phone:918-588-1900
Practice Address - Fax:918-582-6405
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177392471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography