MEDICARE: DR. LINDA M. INGRAHAM PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	22872	TX
2	103TF0200X	Forensic Psychologist	22872	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00B12A	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356547665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA M. INGRAHAM PH.D.

Provider Business Mailing Address
First Line	:	3131 TURTLE CREEK BLVD
Second Line	:	SUITE 1026
City	:	DALLAS
State	:	TX
Zip	:	75219-5426
Country	:	US
Telephone Number	:	214-219-1031
Fax Number	:	214-522-0916

Provider Business Practice Location Address
First Line	:	3131 TURTLE CREEK BLVD
Second Line	:	SUITE 1026
City	:	DALLAS
State	:	TX
Zip	:	75219-5426
Country	:	US
Telephone Number	:	214-219-1031
Fax Number	:	214-522-0916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2007
Last Update Date	:	09/11/2025

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