NPIMap

Organization Active NPI

Legacy Vision PA

  • Optometrist
  • Plano, TX
National Provider Identifier
1770769804
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
03489TG Issued in TX
Legal business name
LEGACY VISION PA
Practice address
6909 Coit Rd
Suite 200
Plano, TX 75024
Phone
(972) 208-5757
Fax
(972) 208-5548
NPI assigned
Jan 18, 2008
Organization subpart
Yes
Parent organization
LEGACY VISION PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Trish E Todd, ABOC
Title
Manager
Phone
(972) 208-5757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 03489TG TX Primary

Addresses

Primary practice location

6909 Coit Rd
Suite 200
Plano, TX 75024

Mailing address

6909 Coit Rd
Suite 200
Plano, TX 75024
Phone (972) 208-5757

Other identifiers 1

IdentifierTypeStateIssuer
00825POtherTXMEDICARE

National Provider Directory

National Provider Directory
Part of
Legacy Vision PA

Locations

6909 Coit Rd
Ste 200
Plano, TX 75024
Phone (972) 208-5757

Practitioners & affiliated clinicians

Practitioners 4

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": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1770769804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 COIT RD",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75024",
            "telephone_number": "972-208-5757",
            "fax_number": "972-208-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 COIT RD",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75024",
            "telephone_number": "972-208-5757",
            "fax_number": "972-208-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY VISION PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY VISION PA",
        "enumeration_date": "2008-01-18",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "TRISH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-208-5757",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "03489TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00825P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.