Provider Demographics
NPI:1063140416
Name:TINDLE, DEBI
Entity type:Individual
Prefix:
First Name:DEBI
Middle Name:
Last Name:TINDLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6713 SERENA LANE
Mailing Address - Street 2:WACO, TEXAS 76712
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705
Mailing Address - Country:US
Mailing Address - Phone:254-744-1793
Mailing Address - Fax:
Practice Address - Street 1:6713 SERENA LANE
Practice Address - Street 2:WACO, TEXAS 76712
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705
Practice Address - Country:US
Practice Address - Phone:254-744-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty