| Diabetes And Thyroid Center Of Fort Worth, Pllc | |
|
6844 Harris Parkway Ft. Worth TX 76132 | |
| (817) 263-0007 | |
| (817) 263-1118 |
| Full Name | Diabetes And Thyroid Center Of Fort Worth, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6844 Harris Parkway, Ft. Worth, Texas |
| Authorized Official Name and Position | Darren Wayne Lackan (OWNER) |
| Authorized Official Contact | 6822251157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Thyroid Center Of Fort Worth, Pllc 6844 Harris Pkwy Ste 300 Fort Worth TX 76132-4281 Ph: (817) 263-0007 | Diabetes And Thyroid Center Of Fort Worth, Pllc 6844 Harris Parkway Ft. Worth TX 76132 Ph: (817) 263-0007 |
| NPI Number | 1326373143 |
|---|---|
| Provider Enumeration Date | 10/13/2009 |
| Last Update Date | 09/23/2025 |
| Medicare PECOS PAC ID | 5597808584 |
|---|---|
| Medicare Enrollment ID | O20100129000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326373143 | NPI | - | NPPES |
| 209175301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Anjanette Sia Lin Tan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154326627 PECOS PAC ID: 7416936919 Enrollment ID: I20100129000301 |
| Provider Name | Lisa D Mijares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134513401 PECOS PAC ID: 1557689841 Enrollment ID: I20150416002350 |
| Provider Name | Rachel Martha Mansheim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386286037 PECOS PAC ID: 8325370745 Enrollment ID: I20191104001713 |
| Provider Name | Suzanne Sophia Wombough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124634621 PECOS PAC ID: 9739594722 Enrollment ID: I20210225001911 |
| Provider Name | Farheen Saeed |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326402504 PECOS PAC ID: 0345594669 Enrollment ID: I20210818003061 |
| Provider Name | Sara Matani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629481957 PECOS PAC ID: 1456570498 Enrollment ID: I20221205001145 |
Superior Evaluation Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Throckmorton Suite 200, Ft. Worth, TX 76102 Phone: 817-863-4315 Fax: 888-575-0212 | |
Darren Lackan M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6844 Harris Parkway, Ft. Worth, TX 76132 Phone: 817-263-0007 Fax: 817-263-1118 |