Healthcare Provider Details

I. General information

NPI: 1386350189
Provider Name (Legal Business Name): LEGACY PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18333 EGRET BAY BLVD STE 635
HOUSTON TX
77058-3860
US

IV. Provider business mailing address

18333 EGRET BAY BLVD STE 635
HOUSTON TX
77058-3860
US

V. Phone/Fax

Practice location:
  • Phone: 832-632-2273
  • Fax:
Mailing address:
  • Phone: 832-632-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CASEY LINDBLADE
Title or Position: OWNER
Credential: RN
Phone: 281-814-0843