Legacy Med LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LEGACY MED LLC

Practice address

10150 Almeda Genoa Rd Ste H
Houston, TX 77075-2435

Phone

(346) 298-1521

Fax

(832) 831-6049

NPI assigned

May 10, 2024

Organization subpart

No

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

Authorized official

Name

Hoang-Anh PhanNPI 1407020035

Title

Managing Member

Phone

(713) 437-7114

Specialties & licenses 2

Addresses

Other names 2

• KVA Pain Solution Doing business as
• Legacy Urgent Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hoang-Anh Lac Phan, D.O

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1407020035
  Medicare reassignment NPD Authorized official
• Huyenvy Van

  • Pharmacist
  • Houston, TX
  • NPI 1215342589
  NPD (past)

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1083462329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 MYSTIC ARBOR LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770773545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 ALMEDA GENOA RD STE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770752435",
            "telephone_number": "346-298-1521",
            "fax_number": "832-831-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "HOANG-ANH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "713-437-7114"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KVA Pain Solution",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Legacy Dental Group, PLLC
• Legacy Healthcare Inc
• Legacy Healthcare Services
• Legacy Heart Care of Houston, LLC
• Legacy Lights & Meters LLC
• Legacy Now Hospice, LLC
• Legacy Outreach Services
• Legacy Providers, LLC
• Legacy Recovery Health Center
• Legacy Recovery Health Center

• Multi-Specialty Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.