Individual
BENJAMIN J. LOCKMILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
110 SUNRISE RIDGE LOOP, AUSTIN, TX 78738-5615
(512) 507-6379
Mailing address
110 SUNRISE RIDGE LOOP, AUSTIN, TX 78738-5615
(512) 507-6379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
670742
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072510
CRNA CERTIFICATE
TX
Enumeration date
03/25/2006
Last updated
05/14/2022
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