Provider Demographics
NPI:1689192403
Name:A NEW DAY PEDIATRIC PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:A NEW DAY PEDIATRIC PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PEDIATRIC PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN-LOUISE
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, ABPP
Authorized Official - Phone:210-816-4149
Mailing Address - Street 1:16607 BLANCO RD STE 1003
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1964
Mailing Address - Country:US
Mailing Address - Phone:210-816-4149
Mailing Address - Fax:210-571-1713
Practice Address - Street 1:16607 BLANCO RD STE 1003
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1964
Practice Address - Country:US
Practice Address - Phone:210-816-4149
Practice Address - Fax:210-571-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34330103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty