Healthcare Provider Details
I. General information
NPI: 1982912127
Provider Name (Legal Business Name): FRANCIS E. TACKA D.O. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3148 MATLOCK RD SUITE 505
ARLINGTON TX
76015-2991
US
IV. Provider business mailing address
3148 MATLOCK RD SUITE 505
ARLINGTON TX
76015-2991
US
V. Phone/Fax
- Phone: 972-988-0844
- Fax: 972-660-1162
- Phone: 972-988-0844
- Fax: 972-660-1162
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANCIS
EUGENE
TACKA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 972-988-0844