Provider Demographics
NPI:1336466101
Name:LOCKETT, PIPER E (PA-C)
Entity Type:Individual
Prefix:
First Name:PIPER
Middle Name:E
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 S COULTER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-3705
Mailing Address - Country:US
Mailing Address - Phone:806-352-5400
Mailing Address - Fax:806-352-8555
Practice Address - Street 1:1301 S COULTER ST
Practice Address - Street 2:SUITE 413
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1763
Practice Address - Country:US
Practice Address - Phone:806-677-7953
Practice Address - Fax:806-353-6081
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA-04369363AM0700X
TXTX4369363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical