Provider Demographics
NPI:1972720696
Name:CHERRY, LYNNA GARLAND (OD)
Entity Type:Individual
Prefix:DR
First Name:LYNNA
Middle Name:GARLAND
Last Name:CHERRY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12702 FOXHOUND CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7235
Mailing Address - Country:US
Mailing Address - Phone:512-258-9009
Mailing Address - Fax:
Practice Address - Street 1:12702 FOXHOUND CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7235
Practice Address - Country:US
Practice Address - Phone:512-258-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6072T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist