=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306145131
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JO LINDSAY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2011
-----------------------------------------------------
Last Update Date | 03/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 555 REPUBLIC DR STE 200
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-5469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-718-1616
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 555 REPUBLIC DR STE 200
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-5469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-718-1616
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | MARY J LINSDAY
-----------------------------------------------------
Credential | APN
-----------------------------------------------------
Telephone | 903-718-1616
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 731298
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------