SHANE M TACKITT

MANSFIELD, TX
NPI1588035976
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: TX  S5274)
Additional Taxonomies208M00000X Hospitalist
(Licence: TX  S5274)
390200000X Student in an Organized Health Care Education/Training Program
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  BP10058725)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  S5274)
Enumeration Date2015-10-12
Last Update Date2020-07-01
Business Address
Dr. SHANE M TACKITT DO
2700 E BROAD ST
MANSFIELD, TX 76063-5899
Phone number: 682-242-6470
Mailing Address
Dr. SHANE M TACKITT DO
2700 E BROAD ST DEPARTMENT INTERNAL MEDICINE
MANSFIELD, TX 76063-5899
Phone number: 682-242-6470