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Individual
DR. JAMES MANNING LACKEY
Active
Individual
DR. JAMES MANNING LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L5014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216649801
—
TX
05
—
216649802
—
TX
01
—
8CJ355
BLUECROSS BLUESHIELD
TX
01
—
L5014
TX LICENSE NUMBER
TX
01
—
Y29190
UPIN NUMBER
TX
Enumeration date
11/28/2006
Last updated
11/01/2012
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