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NPI Code Detail

MEDICARE: MS. MARY LOCKE LCSW

MEDICARE: MS. MARY LOCKE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker29453TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164623310
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY LOCKE LCSW
Provider Business Mailing Address
First Line : 5901 LONG DR
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1003
Country : US
Telephone Number : 713-970-4300
Fax Number : 713-970-6021
Provider Business Practice Location Address
First Line : 5901 LONG DR
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1003
Country : US
Telephone Number : 713-970-4300
Fax Number : 713-970-6021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 12/14/2010

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