MEDICARE: LEGACY PHYSIATRY GROUP MISSOURI, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1366838658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY PHYSIATRY GROUP MISSOURI, LLC

Provider Business Mailing Address
First Line	:	850 CENTRAL PKWY E
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-5561
Country	:	US
Telephone Number	:	972-372-1663
Fax Number	:	972-372-1657

Provider Business Practice Location Address
First Line	:	3636 S GEYER RD
Second Line	:	100
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1237
Country	:	US
Telephone Number	:	972-372-1663
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. VIVEK SASTRY
Credential	:	DO
Telephone Number	:	972-372-1663

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	04/13/2015

Similar Medicare Providers

1699608406 — AIMEE CHASTAIN
Practice Location Address:

3636 S GEYER RD STE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 314-279-9751
Practice Fax:

1588999643 — DR. MICHAEL E. MAHON PSY.D., LPC
Practice Location Address:

3636 S GEYER RD STE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 314-910-0758
Practice Fax:

1982029518 — HARDIN HOME HEALTH LLC
Practice Location Address:

3636 S GEYER RD , SUITE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 314-499-8825
Practice Fax: 314-667-5305

1750708194 — ALL ABOUT CARE CONSUMER DIRECTED SERVICES, LLC
Practice Location Address:

3636 S GEYER RD STE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 314-238-7320
Practice Fax: 314-238-7201

1205255098 — COMPASSIONATE HEALTH CARE, INC.
Practice Location Address:

3636 S GEYER RD , SUITE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 314-238-7400
Practice Fax: 314-238-7401

1477901684 — MR. HERSI HERSI
Practice Location Address:

3636 S GEYER RD STE 100
SAINT LOUIS, MO
63127-1237

Practice Phone: 858-752-7052
Practice Fax:

Directions to “LEGACY PHYSIATRY GROUP MISSOURI, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.