Provider Demographics
NPI:1194809418
Name:POTTER, LINDA KAY (BC HIS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:KAY
Last Name:POTTER
Suffix:
Gender:F
Credentials:BC HIS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1114 ASHDALE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2701
Mailing Address - Country:US
Mailing Address - Phone:713-480-5037
Mailing Address - Fax:940-264-4330
Practice Address - Street 1:4504 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-3741
Practice Address - Country:US
Practice Address - Phone:940-264-4327
Practice Address - Fax:940-264-4330
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50514237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist