NPI Code Details Logo

NPI 1871639757

NPI 1871639757 : DARREN LACKAN M.D., P.A. : FT. WORTH, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1871639757
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DARREN LACKAN M.D., P.A. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/29/2007
-----------------------------------------------------
    Last Update Date     |    09/23/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    6844 HARRIS PARKWAY 
-----------------------------------------------------
    City                 |    FT. WORTH
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    76132
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    817-263-0007
-----------------------------------------------------
    Fax                  |    817-263-1118
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6844 HARRIS PKWY STE 300 
-----------------------------------------------------
    City                 |    FORT WORTH
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    76132-4281
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    817-263-0007
-----------------------------------------------------
    Fax                  |    817-263-1118
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     DARREN WAYNE LACKAN 
-----------------------------------------------------
    Credential           |    MD
-----------------------------------------------------
    Telephone            |    682-225-1157
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207RE0101X
-----------------------------------------------------
    Taxonomy Name        |    Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
    License Number       |    L6481
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.