Organization
LEGACY DME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCOS LOPEZ JR. (ADMINISTRATOR)
(956) 687-3631
Entity
Organization
Contact information
Practice address
1900 S JACKSON, STE 5, MCALLEN, TX 78503-1589
(956) 687-3631
(956) 687-3633
Mailing address
505 ANGELITA DR, STE 7, WESLACO, TX 78596-4693
(956) 358-4572
(956) 583-9333
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203367202
—
TX
Enumeration date
07/02/2008
Last updated
10/05/2010
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