Organization
LEGENT PHYSICIAN GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BRAZELL (CHIEF OPERATING OFFICER)
(310) 339-6824
Entity
Organization
Contact information
Practice address
4090 MAPLESHADE LN STE 210, PLANO, TX 75093-0026
(214) 544-6290
Mailing address
4090 MAPLESHADE LN STE 220, PLANO, TX 75093-0026
(817) 421-1066
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
12/01/2022
Last updated
01/09/2026
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