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General NPI Number Information
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NPI Number | 1760632723
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Entity Type | Organization
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Legal Business Name | LEGACY ANESTHESIA CONSULTANTS, PLLC
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 401 W CAMPBELL RD
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City | RICHARDSON
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State | TX
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Zip | 75080-3416
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Country | US
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Telephone | 814-516-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 4275 LITTLE RD SUITE 202
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City | ARLINGTON
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State | TX
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Zip | 76016-5600
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Country | US
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Telephone | 817-516-8811
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY N MARKS
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Credential | M.D.
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Telephone | 469-237-6526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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