Provider Demographics
NPI:1144437278
Name:HATCHETT, LYNSEY AMANDA (PT)
Entity type:Individual
Prefix:
First Name:LYNSEY
Middle Name:AMANDA
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LYNSEY
Other - Middle Name:AMANDA
Other - Last Name:PULLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT
Mailing Address - Street 1:P.O. BOX 2500
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-9000
Mailing Address - Country:US
Mailing Address - Phone:972-771-0999
Mailing Address - Fax:972-777-1228
Practice Address - Street 1:1010 N. BELTLINE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1774
Practice Address - Country:US
Practice Address - Phone:972-288-2400
Practice Address - Fax:972-288-0222
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3102980225100000X
TX1172370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T8598OtherBCBS
TX165348701Medicaid
TX8K9401Medicare PIN
TX8T8598OtherBCBS
TX165348701Medicaid