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General NPI Number Information
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NPI Number | 1326838723
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Entity Type | Organization
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Legal Business Name | LOCKHART I ENTERPRISES, L.L.C.
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 107 N MEDINA ST
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City | LOCKHART
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State | TX
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Zip | 78644-1919
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Country | US
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Telephone | 512-398-5213
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Fax | 512-398-9458
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Provider Business Mailing Address
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Address Line | 4150 INTERNATIONAL PLZ STE 200
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City | FORT WORTH
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State | TX
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Zip | 76109-4875
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Country | US
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Telephone | 817-386-8410
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. GARY BLAKE
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Credential |
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Telephone | 817-348-8959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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