Organization
LEGACY EYELIDS & COSMETIC SURGERY
Active
Organization
LEGACY EYELIDS & COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNA KALYAM MD (PRESIDENT & CEO)
(214) 666-4663
Entity
Organization
Contact information
Practice address
601 W FM 544 STE 102, MURPHY, TX 75094-4232
(214) 666-4663
Mailing address
5760 LEGACY DR STE B3-154, PLANO, TX 75024-7102
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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