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General NPI Number Information
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NPI Number | 1780541219
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Entity Type | Organization
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Legal Business Name | TRUST LEGACY HEALTHCARE INC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 5101 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1625
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Country | US
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Telephone | 316-558-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 5101 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1625
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Country | US
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Telephone | 316-558-5808
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | BRYAN LOZANO
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Credential |
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Telephone | 316-558-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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