IndividualActive
Lance Wilke, ATC, LAT, CSCS, PES
NPI 1225235666 · Athletic Trainer · Ingram, TX
Provider details
- NPI number
- 1225235666
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC, LAT, CSCS, PES
- Sex
- Male
- Sole proprietor
- Yes
- License
- AT1583 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
101 Hillside Dr
Ingram, TX 78025-3126
Phone: (830) 367-2803
Approximate (ZIP-level) locationGet directions
Mailing address
101 Hillside Dr
Ingram, TX 78025-3126
Registry dates
- Enumerated
- 2007-06-29
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.