Provider Demographics
NPI:1588151054
Name:LINDSEY, GREG (REEGT, CLTM)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:REEGT, CLTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 GLADE RD # 2
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4227
Mailing Address - Country:US
Mailing Address - Phone:817-343-8117
Mailing Address - Fax:
Practice Address - Street 1:1100 GLADE RD # 2
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-4227
Practice Address - Country:US
Practice Address - Phone:817-343-8117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4016246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic