LEGACY HEALTHCARE NPI 1912496985

NPI Information

  • NPI: 1912496985
  • Provider Name: LEGACY HEALTHCARE
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Organization
  • Address: 1918 SANTA ANNA DR
    ARLINGTON, TX
    ZIP 76001
  • Phone: (817) 201-4503

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NPI Details

LEGACY HEALTHCARE is a gerontology nurse practitioner in Arlington, TX. LEGACY HEALTHCARE NPI is 1912496985. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1918 SANTA ANNA DR
ARLINGTON, TX
ZIP 76001-611
Phone: (817) 201-4503
Fax: (682) 238-3180

The provider's authorized official is Yonah Knuckles .
The authorized official title is Administrator and has the following contact phone number (817) 201-4503.

The enumeration date for this NPI number is 5/5/2018 and was last updated on 5/5/2018.

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
1363LG0600XNurse PractitionerGerontologyAG03180006TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========OTHERTEXASTAX ID

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: 11/21/2025

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