Provider Demographics
NPI:1205151982
Name:LOVITT, JOHN WALTON
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WALTON
Last Name:LOVITT
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 1:8930 FOURWINDS DR.
Mailing Address - Street 2:335
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1925
Mailing Address - Country:US
Mailing Address - Phone:210-473-4246
Mailing Address - Fax:
Practice Address - Street 1:8930 FOURWINDS DR
Practice Address - Street 2:335
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-1970
Practice Address - Country:US
Practice Address - Phone:210-473-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health