Healthcare Provider Details

I. General information

NPI: 1194158170
Provider Name (Legal Business Name): LINCOLN DEVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22820 INTERSTATE 45 N BUILDING 4 SUITE C
SPRING TX
77373-8206
US

IV. Provider business mailing address

PO BOX 9359
THE WOODLANDS TX
77387-9359
US

V. Phone/Fax

Practice location:
  • Phone: 281-288-2711
  • Fax:
Mailing address:
  • Phone: 281-288-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK FARIAS
Title or Position: MANAGER
Credential:
Phone: 281-288-2711