Organization
HETTIE LEGG & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN L MILLER (BUSINESS MANAGER)
(936) 556-2157
Entity
Organization
Contact information
Practice address
817 N MOUND ST, NACOGDOCHES, TX 75961-4427
(936) 564-6907
(936) 564-0509
Mailing address
817 N MOUND ST, NACOGDOCHES, TX 75961-4427
(936) 564-6907
(936) 564-0509
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210009101
—
TX
01
—
509554
BCBS
TX
Enumeration date
07/09/2008
Last updated
02/16/2023
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