Healthcare Provider Details

I. General information

NPI: 1710373105
Provider Name (Legal Business Name): LINDSEY E. RICHARDS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LINDSEY E. BRISTOW

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 RANCH ROAD 620 S STE 200
LAKEWAY TX
78734-5304
US

IV. Provider business mailing address

401 RANCH ROAD 620 S STE 200
LAKEWAY TX
78734-5304
US

V. Phone/Fax

Practice location:
  • Phone: 512-610-0549
  • Fax: 512-666-3744
Mailing address:
  • Phone: 512-610-0549
  • Fax: 512-666-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberS3056
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: