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Individual

DR. LANCE TREXLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
4141 SHORE DR, INDIANAPOLIS, IN 46254-2607
(317) 329-2000
Mailing address
9531 VALPARAISO CT, INDIANAPOLIS, IN 46268-1130
(317) 879-8940

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20010506A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000353205
ANTHEM BCBS
IN
01
016772
SIHO
IN
05
100063230
IN
Enumeration date
04/03/2007
Last updated
07/01/2011
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