Provider Demographics
NPI:1831329648
Name:MATHIS, LINDSIE MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:LINDSIE
Middle Name:MARIE
Last Name:MATHIS
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 1:601 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-6219
Mailing Address - Country:US
Mailing Address - Phone:806-293-1376
Mailing Address - Fax:806-291-8700
Practice Address - Street 1:601 W 7TH
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-6219
Practice Address - Country:US
Practice Address - Phone:806-293-1376
Practice Address - Fax:806-291-8700
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7440T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8L22857Medicare PIN