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NPI Code Detail

MEDICARE: LEIGH LYNDE NP

MEDICARE: LEIGH LYNDE NP
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
1363LF0000XFamily Nurse Practitioner255785TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699860965
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIGH LYNDE NP
Provider Business Mailing Address
First Line : 580 S DENTON TAP RD
Second Line :
City : COPPELL
State : TX
Zip : 75019-4098
Country : US
Telephone Number : 972-462-0762
Fax Number : 972-393-2133
Provider Business Practice Location Address
First Line : 580 S DENTON TAP RD
Second Line :
City : COPPELL
State : TX
Zip : 75019-4098
Country : US
Telephone Number : 972-462-0762
Fax Number : 972-393-2133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 05/21/2015

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Directions to “ LEIGH LYNDE NP” Practice Location

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