Organization Active NPI

Legent Outpatient Imaging Frisco LLC

  • Diagnostic Radiology Physician
  • Frisco, TX
National Provider Identifier
1679196018
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
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

Updated by the provider on Apr 10, 2023

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)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20200716000404 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7618391269 Practice locations: Frisco, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

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.

Verify at the official NPI Registry.