Provider Demographics
NPI:1376334409
Name:LOCKWOOD, RENEE (PA)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11538
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547-1538
Mailing Address - Country:US
Mailing Address - Phone:325-201-7217
Mailing Address - Fax:
Practice Address - Street 1:3800 S W S YOUNG DR STE 201
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3340
Practice Address - Country:US
Practice Address - Phone:254-245-9175
Practice Address - Fax:254-245-9175
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant