MR. THOMAS BRITT LACKEY (NPI# 1205904174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205904174 |
| Entity Type | Individual |
| Full Name | MR. THOMAS BRITT LACKEY |
| Credential | ENP |
| Practice Address |
3195 Dowlen Rd Ste 105 Beaumont TX 77706-7272 |
| Mailing Address |
Po Box 7714 Beaumont TX 77726-7714 |
| Practice Telephone | 4098931177 |
| Mailing Telephone | 4098931177 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-11-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
641335 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720060247 | Thomas Kevin Lackey | Anesthesiology | 3804 Rainbow Dr, Rainbow City, AL 35906 | 2005-11-18 |
| 1114955598 | Thomas C. Lackey II | Surgery | 4759 Lakeview Dr, Ste 101, Sebring, FL 33870-2005 | 2006-06-28 |
| Street Address |
3195 DOWLEN RD STE 105 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706-7272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104184845 | Tara Boudoin Deville | Nurse Practitioner | 3195 Dowlen Rd Ste 105, Beaumont, TX 77706 | 2012-05-01 |
| 1841525235 | Doctors Express of The Beaumont Area Pa | Clinic/Center | 3195 Dowlen Rd Ste 105, Beaumont, TX 77706 | 2009-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033725718 | Wendi Ellen Ames | Nurse Practitioner | 350 Pine St Ste 755, Beaumont, TX 77701-2437 | 2020-09-18 |
| 1093340697 | Amber Tenille Goldsmith | Nurse Practitioner | 4347 Phelan Blvd, Beaumont, TX 77707-2159 | 2020-03-04 |
| 1851925267 | Trey Perkins | Nurse Practitioner | 3650 N Major Dr Ste A, Beaumont, TX 77713-9573 | 2020-02-25 |
| 1972141158 | Lisa Marie Davila | Nurse Practitioner | 14870 Michelle Ln, Beaumont, TX 77713-2308 | 2019-12-18 |
| 1467095224 | Fines Pafira Pruett | Nurse Practitioner | 35232 Hogan Dr, Beaumont, CA 92223-7407 | 2019-10-24 |
| 1952944399 | Kevin Ray Jones | Nurse Practitioner | 6040 Carrie Ln, Beaumont, TX 77713-4192 | 2019-10-17 |
| 1447891320 | Summer Mcclain | Nurse Practitioner | 740 Hospital Dr Ste 250, Beaumont, TX 77701-4666 | 2019-10-02 |
| 1114579059 | Amy Rae Hederman | Nurse Practitioner | 3070 College St Ste 100b, Beaumont, TX 77701-4652 | 2019-07-11 |
| 1245898808 | Primary Care Anywhere, Pllc | Nurse Practitioner | 4347 Phelan, Suite 101, Beaumont, TX 77707 | 2019-05-30 |
| 1548824253 | Lisa Marie Leger | Nurse Practitioner | 3129 College St Ste 200, Beaumont, TX 77701-4682 | 2019-04-29 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.