Legacy Md | |
4040 Legacy Dr Ste 104 Frisco TX 75034-6748 | |
(469) 200-8046 | |
Not Available |
Full Name | Legacy Md |
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Speciality | Internal Medicine |
Location | 4040 Legacy Dr Ste 104, Frisco, Texas |
Authorized Official Name and Position | Ousama Moammar (CEO) |
Authorized Official Contact | 2144712808 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Legacy Md 4040 Legacy Dr Ste 104 Frisco TX 75034-6748 Ph: () - | Legacy Md 4040 Legacy Dr Ste 104 Frisco TX 75034-6748 Ph: (469) 200-8046 |
NPI Number | 1396250577 |
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Provider Enumeration Date | 12/09/2017 |
Last Update Date | 12/09/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396250577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | N5873 (Texas) | Primary |
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