Healthcare Provider Details

I. General information

NPI: 1619077096
Provider Name (Legal Business Name): LOCKHART FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 W. SAN ANTONIO ST.
LOCKHART TX
78644
US

IV. Provider business mailing address

1009 W. SAN ANTONIO ST.
LOCKHART TX
78644
US

V. Phone/Fax

Practice location:
  • Phone: 512-376-5247
  • Fax: 512-376-6252
Mailing address:
  • Phone: 512-376-5247
  • Fax: 512-376-6252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF1226
License Number StateTX

VIII. Authorized Official

Name: DR. BARTON JAMES ROMANEK
Title or Position: OWNER
Credential: M.D.
Phone: 512-376-5247