| Doctor Name: | LACY PITCHFORD |
| NPI Number: | 1003235672 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 684218 |
| Business Practice Address: | 801 Matlock Rd Mansfield, TX - 76063 |
| Business Phone Number: | 8173478420 |
| Business Fax Number: | 8173478425 |
| Mailing Address: | Po Box 99213, FORT WORTH |
| State: | TX |
| Postal Code: | 761990213 |
| Phone Number: | 6828852654 |
| Fax Number: | 6828853639 |
| NPI Enumeration Date: | 04/10/2014 |
| NPI Last Update Date: | 04/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 684218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |