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General NPI Number Information
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NPI Number | 1699806018
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Entity Type | Organization
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Legal Business Name | LEGACY SURGERY CENTER OF FRISCO LP
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 5616 WARREN PARKWAY SUITE 100 & 100A
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 972-712-4800
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Fax | 972-712-4808
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Provider Business Mailing Address
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Address Line | 5616 WARREN PARKWAY SUITE 100 & 100A
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 972-712-4800
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Fax | 972-712-4808
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JEFFREY P BUCH
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Credential | MD
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Telephone | 972-612-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | TX
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