NPIMap

Organization Active NPI

Legacy Laboratory

  • Clinical Medical Laboratory
  • The Woodlands, TX
National Provider Identifier
1013250356
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
54411 Issued in CA
Legal business name
LEGACY LABORATORY
Practice address
26010 Oak Ridge Dr
Ste 100
The Woodlands, TX 77380-1972
Phone
(281) 292-7411
Fax
(281) 292-7481
NPI assigned
Apr 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thinh Phan, MD
Title
Owner
Phone
(281) 292-7411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 54411 CA Primary

Addresses

Primary practice location

26010 Oak Ridge Dr
Ste 100
The Woodlands, TX 77380-1972

Mailing address

1544 Sawdust Rd
Ste 280
Spring, TX 77380-2929
Phone (281) 292-7411

National Provider Directory

National Provider Directory

Locations

26010 Oak Ridge Dr
Ste 100
The Woodlands, TX 77380
Phone (281) 245-0288

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1013250356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 SAWDUST RD",
            "address_2": "STE 280",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802929",
            "telephone_number": "281-292-7411",
            "fax_number": "281-292-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26010 OAK RIDGE DR",
            "address_2": "STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801972",
            "telephone_number": "281-292-7411",
            "fax_number": "281-292-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "THINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-292-7411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "54411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.