Provider Demographics
NPI:1205027380
Name:LOCKHART, ANN-LOUISE THERESA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANN-LOUISE
Middle Name:THERESA
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:PSYD
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Other - Credentials:
Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:BLDG 3600, DEPARTMENT OF BEHAVIORAL MEDICINE
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-1771
Mailing Address - Fax:210-916-4040
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:BLDG 3600, DEPARTMENT OF BEHAVIORAL MEDICINE
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-1771
Practice Address - Fax:210-916-4040
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
103TC2200X
TX34330103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent