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Individual

REGINALD BRUCE LEGROW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
402 N KAUFMAN ST, LINDEN, TX 75563-5234
(903) 756-5581
(903) 756-5005
Mailing address
404 N KAUFMAN ST, LINDEN, TX 75563-5234
(903) 756-5581
(903) 756-5005

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G1944
TX
208000000X
Pediatrics Physician
G1944
TX
208D00000X
General Practice Physician
Primary
G1944
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130943702
TX
Enumeration date
08/24/2005
Last updated
09/23/2013
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