Individual provider Active NPI

Malkishuana Malkeil Lacy, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1396917514
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7205TG Issued in TX
Practice address
4444 W Jefferson Blvd
Ste 614
Dallas, TX 75211-4600
Phone
(214) 333-3937
Fax
(214) 331-2021
NPI assigned
Mar 27, 2008
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7205TG TX Primary

Addresses

Primary practice location

4444 W Jefferson Blvd
Ste 614
Dallas, TX 75211-4600

Mailing address

4444 W Jefferson Blvd
Ste 614
Dallas, TX 75211-4600
Phone (214) 333-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000559 TX Practitioner - Optometry 3274704143 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7205TXMDGeneral Practice Dentistry
7205TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lacy Eye Care Services PC Optometrist CurrentSince Aug 26, 2012 Accepting new patients
Michael T Poynor OD PA Optometrist PastSince Feb 2, 2012 Accepting new patients
Lindsey Alexander OD PA Optometrist PastSince May 2, 2012 Accepting new patients

Locations

4444 W Jefferson Blvd
Ste 614
Dallas, TX 75211
Phone (214) 613-1111

1380 Highway 287 N
Ste 104
Mansfield, TX 76063
Phone (817) 305-8088

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1396917514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W JEFFERSON BLVD",
            "address_2": "STE 614",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752114600",
            "telephone_number": "214-333-3937",
            "fax_number": "214-331-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W JEFFERSON BLVD",
            "address_2": "STE 614",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752114600",
            "telephone_number": "214-333-3937",
            "fax_number": "214-331-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "MALKISHUANA",
        "middle_name": "MALKEIL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7205TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.