Individual
SHAZIA LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP-PC
Contact information
Practice address
4120 N COLLINS ST STE 200, ARLINGTON, TX 76005-4554
(817) 372-2283
Mailing address
2104 COOLIDGE DR, ARLINGTON, TX 76011-3206
(817) 312-3396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP143474
TX
Other
Enumeration date
10/21/2019
Last updated
01/27/2020
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