Most Relevant Information
Provider Data
| NPI Number: | 1003828575 |
| Provider Name: | KELLY LOCK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA04685 |
Most Important Dates
| Enumeration Date: | 08/13/2006 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
6450 FOLSOM DR
BEAUMONT
TX
777067269
Practice Location Phone/Fax
| Phone: | 4098350524 |
| Fax: | 4098350632 |
Provider Mailing Location
1220 HILLSIDE LN
LUMBERTON
TX
776579056
Provider Mailing Phone/Fax
| Phone: | 4097550980 |
| Fax: |