Organization
LEGACY VASCULAR LABS OF AMERICA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RYAN (MANAGING MEMBER)
(972) 345-7890
Entity
Organization
Contact information
Practice address
7711 SAN JACINTO PL STE 200, PLANO, TX 75024-3296
(972) 345-7890
Mailing address
PO BOX 191634, DALLAS, TX 75219-8503
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
10/18/2022
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