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General NPI Number Information
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NPI Number | 1073724571
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Entity Type | Organization
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Legal Business Name | L BRADLEY LOCKHART MD PA
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 2727 GRAMERCY ST
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City | HOUSTON
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State | TX
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Zip | 77025-1617
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Country | US
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Telephone | 713-799-9975
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Fax | 713-458-8362
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Provider Business Mailing Address
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Address Line | 1912 W 35TH ST
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City | AUSTIN
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State | TX
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Zip | 78703-1324
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Country | US
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Telephone | 512-458-1922
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Fax | 512-458-8362
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. L BRADLEY LOCKHART
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Credential | M.D.
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Telephone | 512-458-1922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | J5192
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License Number State | TX
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