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General NPI Number Information
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NPI Number | 1386350189
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Entity Type | Organization
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Legal Business Name | LEGACY PROVIDERS, LLC
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 18333 EGRET BAY BLVD STE 635
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City | HOUSTON
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State | TX
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Zip | 77058-3860
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Country | US
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Telephone | 832-632-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 18333 EGRET BAY BLVD STE 635
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City | HOUSTON
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State | TX
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Zip | 77058-3860
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Country | US
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Telephone | 832-632-2273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CASEY LINDBLADE
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Credential | RN
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Telephone | 281-814-0843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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