Individual
LINDI RENEA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
923 PENNSYLVANIA AVENUE, SUITE 100, FORT WORTH, TX 76104-2254
(817) 920-0484
(817) 920-0068
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 920-0068
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
60530
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186205401
—
TX
01
—
186205402
MEDICAID CSHCN
TX
01
—
P00422596
RAILROAD MEDICARE
—
Enumeration date
05/24/2007
Last updated
09/30/2011
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