1548997653 NPI number — LINDSAY LEIGH SHEAFFER

Table of content: LINDSAY LEIGH SHEAFFER (NPI 1548997653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548997653 NPI number — LINDSAY LEIGH SHEAFFER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEAFFER
Provider First Name:
LINDSAY
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548997653
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6603 ROSEBROOK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KLEIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-4159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-484-6228
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6603 ROSEBROOK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KLEIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77379-4159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-484-6228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1063552354 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com