Provider Demographics
NPI:1053514257
Name:LINDLEY, KATARINA (DO)
Entity type:Individual
Prefix:DR
First Name:KATARINA
Middle Name:
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8246
Mailing Address - Country:US
Mailing Address - Phone:940-328-6404
Mailing Address - Fax:940-328-6523
Practice Address - Street 1:202 SW 25TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8242
Practice Address - Country:US
Practice Address - Phone:940-328-6521
Practice Address - Fax:940-328-7501
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56702-21207Q00000X
TXQ2327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI07455/0409Medicare PIN
TX396472YMC1Medicare PIN