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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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