Provider Demographics
NPI:1508839036
Name:RICHARD C. LOCK, M.D., P.A.
Entity Type:Organization
Organization Name:RICHARD C. LOCK, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-752-8745
Mailing Address - Street 1:PO BOX 1920
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-1920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12121 RICHMOND AVE., SUITE 413
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082
Practice Address - Country:US
Practice Address - Phone:281-752-8745
Practice Address - Fax:281-752-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1552879Medicaid
TX0083HLOtherBLUECROSS BLUESHIELD
TXF86365Medicare UPIN
TX1552879Medicaid