Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lacy R Stark, PA

Individual provider Nurse Practitioner · NPI 1922510205

Lacy R Stark, PA is a Nurse Practitioner in Fort Worth, Texas. Qualified in 2017, 9 years ago. Practices with Clinical Neuroscience PA, a 3-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
9
Licensed in
TX
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1307 8th Ave Ste 608
Fort Worth, TX 76104-4140
Phone: (817) 921-4191
Fax: (817) 429-7783
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP135511 (TX)

Record details

NPI number1922510205
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 26, 2017
Last updated in NPPESApril 29, 2024
Certification dateApril 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Clinical Neuroscience Pa — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fort Worth