MEDICARE: ENGELYN LEGASPI

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	163WG0000X	General Practice Registered Nurse	867367	TX

General Provider Information

NPI Number	:	1780512533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENGELYN LEGASPI

Provider Business Mailing Address
First Line	:	6328 COPPERHEAD DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3191
Country	:	US
Telephone Number	:	940-594-6317
Fax Number	:

Provider Business Practice Location Address
First Line	:	6328 COPPERHEAD DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3191
Country	:	US
Telephone Number	:	940-594-6317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ ENGELYN LEGASPI ” Practice Location

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