NPIMap

Organization Active NPI

Legacy Dental Sa PC

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1992154033
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13977 Issued in TX
Legal business name
LEGACY DENTAL SA PC
Practice address
13205 George Rd
San Antonio, TX 78230-3018
Phone
(210) 492-0205
Fax
(210) 492-0305
NPI assigned
Jun 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Dr. Brian Leroy Eck, DDSNPI 1730192287
Title
Dentist/ Owner
Phone
(210) 492-0205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 13977 TX Primary

Addresses

Primary practice location

13205 George Rd
San Antonio, TX 78230-3018

Mailing address

13205 George Rd
San Antonio, TX 78230-3018
Phone (210) 492-0205

National Provider Directory

National Provider Directory

Locations

13205 George Rd
San Antonio, TX 78230
Phone (210) 492-0205

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": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1992154033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13205 GEORGE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303018",
            "telephone_number": "210-492-0205",
            "fax_number": "210-492-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13205 GEORGE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303018",
            "telephone_number": "210-492-0205",
            "fax_number": "210-492-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL SA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "ECK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "210-492-0205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.