MEDICARE: LEGEND PROVIDER SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1851935944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGEND PROVIDER SERVICES, INC

Provider Business Mailing Address
First Line	:	2600 S LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2603
Country	:	US
Telephone Number	:	346-320-4187
Fax Number	:	346-320-4129

Provider Business Practice Location Address
First Line	:	2600 S LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2603
Country	:	US
Telephone Number	:	346-320-4187
Fax Number	:	346-320-4129

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. VINCENT E UZOMAH
Credential	:
Telephone Number	:	713-530-7867

Provider Enumeration Date	:	10/31/2019
Last Update Date	:	01/27/2026

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Directions to “LEGEND PROVIDER SERVICES, INC ” Practice Location

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