Most Relevant Information
Provider Data
| NPI Number: | 1003235672 |
| Provider Name: | LACY PITCHFORD CPNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | 684218 |
Most Important Dates
| Enumeration Date: | 04/10/2014 |
| Last Updated: | 05/08/2024 |
Provider Practice Location
1263 W ROSEDALE ST STE 200
FORT WORTH
TX
761042837
Practice Location Phone/Fax
| Phone: | 8173364896 |
| Fax: | 8173322805 |
Provider Mailing Location
PO BOX 733784
DALLAS
TX
753733784
Provider Mailing Phone/Fax
| Phone: | 6828851855 |
| Fax: | 6828851396 |