| Advanced Institute for Diabetes & Endocrinology | |
|
1900 Matlock Rd Ste 304 Mansfield TX 76063-4435 | |
| (817) 380-4880 | |
| (817) 788-8416 |
| Full Name | Advanced Institute for Diabetes & Endocrinology |
|---|---|
| Speciality | Internal Medicine |
| Location | 1900 Matlock Rd Ste 304, Mansfield, Texas |
| Authorized Official Name and Position | Lindsey Vandyke (PHYSICIAN/MANAGING DIRECTOR) |
| Authorized Official Contact | 8173804880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Institute for Diabetes & Endocrinology 1900 Matlock Rd Ste 304 Mansfield TX 76063-4435 Ph: (817) 380-4880 | Advanced Institute for Diabetes & Endocrinology 1900 Matlock Rd Ste 304 Mansfield TX 76063-4435 Ph: (817) 380-4880 |
| NPI Number | 1316558349 |
|---|---|
| Provider Enumeration Date | 08/13/2020 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/11/2020 |
| Medicare PECOS PAC ID | 7012320468 |
|---|---|
| Medicare Enrollment ID | O20210105000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316558349 | NPI | - | NPPES |
| R7919 | Other | TX | MEDICAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Primary |
| Provider Name | Lindsey Vandyke |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1871998880 PECOS PAC ID: 8426343427 Enrollment ID: I20181015002105 |
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