Search › Texas › 207R00000X
Shane Tackitt, DO
NPI 1588035976 · on the registry since 2015
Practice
- Address
- 2700 E Broad St
Mansfield, TX 76063 - Phone
- (682) 242-6470
- Fax
- (682) 622-2092
- Organisation at this address
- Newlands Inpatient Services
Methodist Hospitals Of Dallas
Arlington Physician Services Pa
Laboratory Physicians Association
Lonestar Hospital Medicine Associates, PaInferred from a shared address, not stated in the registry. - Clinicians at this address
- 43
Registry record
- Primary taxonomy
- 207R00000X
207R00000X
- Also registered as
- 208M00000X
390200000X
390200000X
390200000X - Licence states on file
- TX, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas