| Darren Lackan M.d., P.a. | |
|
7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 | |
| (817) 263-0007 | |
| (817) 263-1118 |
| Full Name | Darren Lackan M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7801 Oakmont Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Darren Lackan (PRESIDENT) |
| Authorized Official Contact | 8172630007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Darren Lackan M.d., P.a. 7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 Ph: (817) 263-0007 | Darren Lackan M.d., P.a. 7801 Oakmont Blvd Suite 101 Fort Worth TX 76132-4204 Ph: (817) 263-0007 |
| NPI Number | 1871639757 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 11/10/2022 |
| Medicare PECOS PAC ID | 4082701982 |
|---|---|
| Medicare Enrollment ID | O20071025000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871639757 | NPI | - | NPPES |
| 190356901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | L6481 (Texas) | Primary |
| Provider Name | Darren W Lackan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053347534 PECOS PAC ID: 5193718914 Enrollment ID: I20040407000471 |
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