Basic Information
Provider Information
NPI: 1043272834
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINDGREN
FirstName: CHERRYLENE
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5219 CITY BANK PKWY STE 35
Address2:  
City: LUBBOCK
State: TX
PostalCode: 79407
CountryCode: US
TelephoneNumber: 8067610333
FaxNumber: 8067820097
Practice Location
Address1: 4105 I-27
Address2:  
City: LUBBOCK
State: TX
PostalCode: 79404
CountryCode: US
TelephoneNumber: 8067622633
FaxNumber: 8067610431
Other Information
ProviderEnumerationDate: 04/05/2006
LastUpdateDate: 03/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XK9108TXY Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XMB070589NJN Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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