| Legends Medical Clinic Pllc | |
|
3000 Joe Dimaggio Blvd Suite 65 Round Rock TX 78664-3990 | |
| (512) 733-6464 | |
| Not Available |
| Full Name | Legends Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3000 Joe Dimaggio Blvd, Round Rock, Texas |
| Authorized Official Name and Position | Xuan Kim Tran (PRESIDENT) |
| Authorized Official Contact | 5127336464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legends Medical Clinic Pllc 3000 Joe Dimaggio Blvd Suite 65 Round Rock TX 78664-3990 Ph: (512) 733-6464 | Legends Medical Clinic Pllc 3000 Joe Dimaggio Blvd Suite 65 Round Rock TX 78664-3990 Ph: (512) 733-6464 |
| NPI Number | 1174721948 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 05/23/2008 |
| Medicare PECOS PAC ID | 9133204571 |
|---|---|
| Medicare Enrollment ID | O20080311000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174721948 | NPI | - | NPPES |
| 0038PX | Other | TX | BCBS OF TEXAS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L8982 (Texas) | Primary |
| Provider Name | Xuan Kim Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134174881 PECOS PAC ID: 4385608645 Enrollment ID: I20041116000875 |
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