Provider Demographics
NPI:1215205216
Name:PICKREL, LINDSEY A (PA)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:A
Last Name:PICKREL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3348
Mailing Address - Country:US
Mailing Address - Phone:281-341-9696
Mailing Address - Fax:281-633-2474
Practice Address - Street 1:1300 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3348
Practice Address - Country:US
Practice Address - Phone:281-341-9696
Practice Address - Fax:281-633-2474
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant