Healthcare Provider Details

I. General information

NPI: 1912535378
Provider Name (Legal Business Name): CASEY JOSEPH LOCKETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN ANTONIO MILITARY MEDICAL CENTER MCHE-MDX 3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-4789
  • Fax:
Mailing address:
  • Phone: 830-310-0623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberT5378
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: