Individual
MR. JEREMY S LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
221 W COLORADO BLVD STE 525, DALLAS, TX 75208-2312
(214) 960-5681
(214) 960-5681
Mailing address
5605 N MACARTHUR BLVD STE 740, IRVING, TX 75038-2626
(214) 960-5681
(214) 960-5681
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP122655
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP122655
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308071505
—
TX
01
—
693349
MEDICARE
TX
01
—
8JX709
BCBS
TX
Enumeration date
08/09/2012
Last updated
11/20/2024
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