LEGACY HEART CARE OF FORT WORTH LLC NPI 1356506752

NPI Information

NPI: 1356506752
Provider Name: LEGACY HEART CARE OF FORT WORTH LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2500 WEST FWY
SUITE 200
FORT WORTH, TX
ZIP 76102
Phone: (817) 423-4400
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LEGACY HEART CARE OF FORT WORTH LLC is a cardiovascular disease internal medicine in Fort Worth, TX. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. LEGACY HEART CARE OF FORT WORTH LLC NPI is 1356506752. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2500 WEST FWY
SUITE 200
FORT WORTH, TX
ZIP 76102-848
Phone: (817) 423-4400
Fax: (817) 423-8080

The provider's authorized official is Michael Gratch .
The authorized official title is President and has the following contact phone number (817) 423-4400.

The enumeration date for this NPI number is 7/24/2008 and was last updated on 11/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA02558	TEXAS	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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