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General NPI Number Information
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NPI Number | 1659485894
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Entity Type | Organization
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Legal Business Name | LEGACY PAIN ASSOCIATES, P.A.
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 9201 PINECROFT DR STE 200
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City | SHENANDOAH
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State | TX
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Zip | 77380-3889
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Country | US
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Telephone | 832-953-2280
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Fax | 832-953-2829
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Provider Business Mailing Address
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Address Line | PO BOX 679113
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City | DALLAS
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State | TX
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Zip | 75267-8205
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Country | US
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Telephone | 832-953-2280
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Fax | 832-953-2829
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Authorized Official
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Title or Position | OWNER, MEDICAL DIRECTOR
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Name | CLAYTON MARK BARHORST
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Credential | M.D.
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Telephone | 832-953-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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