Provider Demographics
NPI:1528093226
Name:LINDELL, NATHAN
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:LINDELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7109 S STAPLES ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5528
Mailing Address - Country:US
Mailing Address - Phone:361-991-4500
Mailing Address - Fax:361-991-4595
Practice Address - Street 1:7109 S STAPLES ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5528
Practice Address - Country:US
Practice Address - Phone:361-991-4500
Practice Address - Fax:361-991-4595
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M0440OtherBCBS
8780B0Medicare PIN
TX8F10190Medicare PIN
TX8M0440OtherBCBS