Basic Information
Provider Information
NPI: 1316387962
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOCKE
FirstName: JOSHUA
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6213 SKYLINE DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770577036
CountryCode: US
TelephoneNumber: 7138804400
FaxNumber: 7138698637
Practice Location
Address1: 6213 SKYLINE DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770577036
CountryCode: US
TelephoneNumber: 7138804400
FaxNumber: 7138698637
Other Information
ProviderEnumerationDate: 06/27/2013
LastUpdateDate: 06/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1230427TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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