# LEGACY HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912496985
- **Authorized official:** YONAH KNUCKLES NURSE PRACTITIONER (ADMINISTRATOR)
- **Authorized official phone:** (817) 201-4503

## Contact information

- **Practice address:** 1918 SANTA ANNA DR, ARLINGTON, TX 76001-5611
- **Practice address phone:** (817) 201-4503
- **Practice address fax:** (682) 238-3180
- **Mailing address:** 1918 SANTA ANNA DR, ARLINGTON, TX 76001-5611
- **Mailing address phone:** (817) 201-4503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | AG03180006 | TX | Yes |

## Other

- **Enumeration date:** 05/05/2018
- **Last updated:** 05/05/2018