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General NPI Number Information
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NPI Number | 1316558349
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Entity Type | Organization
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Legal Business Name | LINDSEY VANDYKE, D.O. PLLC
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 1900 MATLOCK RD STE 304
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City | MANSFIELD
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State | TX
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Zip | 76063-4435
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Country | US
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Telephone | 817-380-4880
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Fax | 817-788-8416
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Provider Business Mailing Address
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Address Line | 1900 MATLOCK RD STE 304
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City | MANSFIELD
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State | TX
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Zip | 76063-4435
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Country | US
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Telephone | 817-380-4880
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Fax | 817-788-8416
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Authorized Official
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Title or Position | PHYSICIAN/MANAGING DIRECTOR
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Name | DR. LINDSEY VANDYKE
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Credential | DO
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Telephone | 817-380-4880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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