Provider Demographics
NPI:1184046682
Name:LOCKETT, NANCY (PT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 KIT CARSON TRL
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4432
Mailing Address - Country:US
Mailing Address - Phone:512-595-0925
Mailing Address - Fax:
Practice Address - Street 1:201 E CENTRAL TEXAS EXPY
Practice Address - Street 2:SUITE 645
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1887
Practice Address - Country:US
Practice Address - Phone:254-415-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist