# LEGACY MEDICAL IMAGING

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHYSICIANS OF KING'S DAUGHTERS, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770852840
- **Legal business name:** PHYSICIANS OF KING'S DAUGHTERS, PA
- **Authorized official:** MR. JIM MADSEN (CHIEF OPERATIONS OFFICER)
- **Authorized official phone:** (254) 298-2490

## Contact information

- **Practice address:** 601 W HWY 6, SUITE 104, WACO, TX 76710-5591
- **Practice address phone:** (254) 741-9729
- **Practice address fax:** (254) 399-0669
- **Mailing address:** 1905 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
- **Mailing address phone:** (254) 298-2490
- **Mailing address fax:** (254) 778-7197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2011
- **Last updated:** 12/20/2011