Provider Demographics
NPI:1740586080
Name:WALKER, LANCE SIMPSON
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:SIMPSON
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 ALMA RD
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2139
Mailing Address - Country:US
Mailing Address - Phone:469-424-6572
Mailing Address - Fax:469-424-6575
Practice Address - Street 1:6051 ALMA RD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2139
Practice Address - Country:US
Practice Address - Phone:469-424-6572
Practice Address - Fax:469-424-6575
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1148897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist