Organization
LEGACY BEHAVIORAL HEALTH & WELLNESS
Active
Parent organization
LEGACY BEHAVIORAL HEALTH & WELLNESS
Other names
Better Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY BEHAVIORAL HEALTH & WELLNESS
Authorized official
MAYRA CRUZ KOEDAM FNP-C, PMHNP-BC (NURSE PRACTITIONER)
(972) 900-8640
Entity
Organization
Contact information
Practice address
8105 RASOR BLVD STE 248, PLANO, TX 75024-0341
(469) 461-1557
Mailing address
3700 LEGACY DR APT 28206, FRISCO, TX 75034-6643
(972) 900-8640
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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