| Legacy Internal Medicine, Pllc | |
|
11330 Legacy Dr Ste 204 Frisco TX 75033-1206 | |
| (469) 731-4200 | |
| (469) 731-4300 |
| Full Name | Legacy Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11330 Legacy Dr Ste 204, Frisco, Texas |
| Authorized Official Name and Position | Urooj Mansoor (OWNER) |
| Authorized Official Contact | 3134149540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Internal Medicine, Pllc 11330 Legacy Dr Ste 204 Frisco TX 75033-1206 Ph: (469) 731-4200 | Legacy Internal Medicine, Pllc 11330 Legacy Dr Ste 204 Frisco TX 75033-1206 Ph: (469) 731-4200 |
| NPI Number | 1134768179 |
|---|---|
| Provider Enumeration Date | 12/21/2019 |
| Last Update Date | 12/21/2019 |
| Medicare PECOS PAC ID | 8729494364 |
|---|---|
| Medicare Enrollment ID | O20210308000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134768179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Urooj Mansoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396839098 PECOS PAC ID: 6507962966 Enrollment ID: I20151112000533 |
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