Provider Demographics
NPI:1124281431
Name:LINDQUIST, TIMOTHY PETERSON (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PETERSON
Last Name:LINDQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28735 PREAKNESS LN
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4837
Mailing Address - Country:US
Mailing Address - Phone:512-289-4337
Mailing Address - Fax:
Practice Address - Street 1:2810 N LOOP 1604 W STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2230
Practice Address - Country:US
Practice Address - Phone:210-822-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9406986207W00000X
MO2012022163207W00000X
TXT7287207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology