Provider Demographics
NPI:1679982169
Name:BERRY, LINDSAY (OD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BERRY
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 1:7140 PRESTON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3278
Mailing Address - Country:US
Mailing Address - Phone:972-312-0177
Mailing Address - Fax:972-491-2020
Practice Address - Street 1:7140 PRESTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3278
Practice Address - Country:US
Practice Address - Phone:972-312-0177
Practice Address - Fax:972-491-2020
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8742T152W00000X
TN3166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist