MEDICARE: LEGIANG HOLDINGS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1710535927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGIANG HOLDINGS LLC

Provider Business Mailing Address
First Line	:	605 TOWNE OAKS DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-5965
Country	:	US
Telephone Number	:	254-399-0788
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 TOWNE OAKS DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-5965
Country	:	US
Telephone Number	:	254-399-0788
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. PHUONG TRAM NGOC LE
Credential	:	MD
Telephone Number	:	912-401-1821

Provider Enumeration Date	:	08/30/2019
Last Update Date	:	08/30/2019

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