Provider Demographics
NPI:1992795934
Name:BAKER, LINDA LERHEA (OD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LERHEA
Last Name:BAKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14711 CHANT ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1109
Mailing Address - Country:US
Mailing Address - Phone:210-479-7907
Mailing Address - Fax:
Practice Address - Street 1:14711 CHANT ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1109
Practice Address - Country:US
Practice Address - Phone:210-479-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4218TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093024001Medicaid
TXT60951Medicare UPIN
TX093024001Medicaid
TX410024006Medicare PIN