Healthcare Provider Details

I. General information

NPI: 1447181185
Provider Name (Legal Business Name): ROBERTO LACHICA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WEST DR
MEMPHIS TN
38112-1728
US

IV. Provider business mailing address

601 WEST DR
MEMPHIS TN
38112-1728
US

V. Phone/Fax

Practice location:
  • Phone: 901-210-1302
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO LACHICA
Title or Position: MD, OWNER
Credential: MD
Phone: 901-210-1302