| Legacy Medical Clinic | |
|
1506 S Lone Star Way Ste 7 Edinburg TX 78539-4977 | |
| (956) 348-2918 | |
| (956) 348-2927 |
| Full Name | Legacy Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1506 S Lone Star Way Ste 7, Edinburg, Texas |
| Authorized Official Name and Position | Leroy Moreno (OWNER) |
| Authorized Official Contact | 9566485011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Medical Clinic 1506 Lonestar Plaza Way Ste 7 Edinburg TX 78539 Ph: () - | Legacy Medical Clinic 1506 S Lone Star Way Ste 7 Edinburg TX 78539-4977 Ph: (956) 348-2918 |
| NPI Number | 1932885126 |
|---|---|
| Provider Enumeration Date | 06/23/2023 |
| Last Update Date | 07/03/2023 |
| Medicare PECOS PAC ID | 0345602827 |
|---|---|
| Medicare Enrollment ID | O20230815003744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932885126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Provider Name | Donna Gail Joule |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407888753 PECOS PAC ID: 1355388380 Enrollment ID: I20100824001240 |
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