Provider Demographics
NPI:1356341390
Name:PARET, GEORGE LOCK III (RPH)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:LOCK
Last Name:PARET
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8216
Mailing Address - Country:US
Mailing Address - Phone:337-477-7115
Mailing Address - Fax:337-477-7126
Practice Address - Street 1:2716 LAKE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8216
Practice Address - Country:US
Practice Address - Phone:337-477-7115
Practice Address - Fax:337-477-7126
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA11073OtherPHARMACIST