# LEGACY PHYSIATRY GROUP NORTH CAROLINA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Legacy Physiatry Group NC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841967064
- **Authorized official:** VENKATESH LAKSHMAN MD (CEO/PRESIDENT)
- **Authorized official phone:** (972) 881-4688

## Contact information

- **Practice address:** 3520 AIRPORT BLVD NW STE D, WILSON, NC 27896-8674
- **Practice address phone:** (855) 655-7777
- **Mailing address:** 850 CENTRAL PKWY E STE 275, PLANO, TX 75074-5542
- **Mailing address phone:** (972) 881-4688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2021
- **Last updated:** 01/05/2022