Active NPI
Legent Outpatient Imaging Frisco LLC
- Diagnostic Radiology Physician
- Frisco, TX
National Provider Identifier
1679196018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- LEGENT OUTPATIENT IMAGING FRISCO LLC
- Practice address
- 8350 Dallas Pkwy Ste 300
Frisco, TX 75034-5076 - Phone
- (469) 294-8974
- Fax
- (469) 294-8832
- NPI assigned
- May 20, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brissa Palacios
- Title
- Director of Operations
- Phone
- (469) 294-8926
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
8350 Dallas Pkwy Ste 300
Frisco, TX 75034-5076
Mailing address
PO Box 6020
Frisco, TX 75035-0225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200716000404 | TX | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 7618391269 | Practice locations: Frisco, TX |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1710121041
Diagnostic Radiology
-
- Neurological Surgery Physician
- Frisco, TX
- NPI 1528262110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589932800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681084800000",
"number": "1679196018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6020",
"city": "FRISCO",
"state": "TX",
"postal_code": "750350225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8350 DALLAS PKWY STE 300",
"city": "FRISCO",
"state": "TX",
"postal_code": "750345076",
"telephone_number": "469-294-8974",
"fax_number": "469-294-8832"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGENT OUTPATIENT IMAGING FRISCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-05-20",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A",
"authorized_official_last_name": "PALACIOS",
"authorized_official_first_name": "BRISSA",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "469-294-8926"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.