Provider Demographics
NPI:1952182156
Name:POMARANTZ, LINDSAY AMANDA (CSFA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:AMANDA
Last Name:POMARANTZ
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 ASPEN WAY
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2607
Mailing Address - Country:US
Mailing Address - Phone:678-457-5704
Mailing Address - Fax:
Practice Address - Street 1:2935 ASPEN WAY
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2607
Practice Address - Country:US
Practice Address - Phone:678-457-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108452246ZC0007X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant