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NPI Code Detail

MEDICARE: LANI K LOCKETT PTA

MEDICARE: LANI K LOCKETT PTA
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
1225200000XPhysical Therapy Assistant2062996TX

General Provider Information

NPI Number : 1124334438
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANI K LOCKETT PTA
Provider Business Mailing Address
First Line : 1600 TEXAS ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3400
Country : US
Telephone Number : 817-338-3405
Fax Number :
Provider Business Practice Location Address
First Line : 1600 TEXAS ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3400
Country : US
Telephone Number : 817-338-3405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2010
Last Update Date : 08/24/2010

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Directions to “ LANI K LOCKETT PTA” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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