Provider Demographics
NPI:1730965757
Name:LOCKHART, MEAGAN (PA-C)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18123 UPPER BAY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3875
Mailing Address - Country:US
Mailing Address - Phone:469-426-1313
Mailing Address - Fax:
Practice Address - Street 1:18123 UPPER BAY RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3875
Practice Address - Country:US
Practice Address - Phone:469-426-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant