Individual provider · Type 1 NPI

Logan Blaise Tackett, DO

Student in an Organized Health Care Education/Training Program · Denton, TX

NPI number 1245178441 Active

Practice location

3535 S I 35 E
Denton, TX 76210-6850

Call (940) 384-3013 Map

Mailing address

128 Central Ave
Pikeville, KY 41501-1354

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245178441

Logan Blaise Tackett, DO's National Provider Identifier is 1245178441, issued on Mar 23, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Denton, TX. The record was last updated on Mar 23, 2026.