Healthcare Provider Details

I. General information

NPI: 1336162064
Provider Name (Legal Business Name): RICHARD H LEGGETT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CITIZENS PLZ SUITE 100
VICTORIA TX
77901-5754
US

IV. Provider business mailing address

1908 N LAURENT ST STE 410
VICTORIA TX
77901-5469
US

V. Phone/Fax

Practice location:
  • Phone: 361-579-1371
  • Fax: 361-579-1373
Mailing address:
  • Phone: 361-572-0333
  • Fax: 361-572-8518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberK4482
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK4482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: