Legacy Vascular Labs of America PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

LEGACY VASCULAR LABS OF AMERICA PLLC

Practice address

7711 San Jacinto PL Ste 200
Plano, TX 75024-3296

Phone

(972) 345-7890

NPI assigned

Jun 4, 2020

Last updated

Oct 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Ryan

Title

Managing Member

Phone

(972) 345-7890

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1770107898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191634",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752198503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 SAN JACINTO PL STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243296",
            "telephone_number": "972-345-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY VASCULAR LABS OF AMERICA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "972-345-7890"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Plano, TX
• Providers in Plano, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.