Provider Demographics
NPI:1932606696
Name:DAVID LINDLEY, DO, PA
Entity Type:Organization
Organization Name:DAVID LINDLEY, DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:940-328-7517
Mailing Address - Street 1:2517 HIGHWAY 180 W STE B
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8297
Mailing Address - Country:US
Mailing Address - Phone:940-328-7517
Mailing Address - Fax:940-325-3002
Practice Address - Street 1:909 SOUTHEAST PKWY STE 104
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-3600
Practice Address - Country:US
Practice Address - Phone:940-328-7517
Practice Address - Fax:940-325-3002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID LINDLEY DO PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4179208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty