| Legacy Community Health Services, Inc | |
|
12540 Sugardale Dr Stafford TX 77477-3702 | |
| (832) 548-5000 | |
| (713) 559-3001 |
| Full Name | Legacy Community Health Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12540 Sugardale Dr, Stafford, Texas |
| Authorized Official Name and Position | Robert Peter Palussek (COO) |
| Authorized Official Contact | 8325485000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Community Health Services, Inc Po Box 66308 Houston TX 77266-6308 Ph: (832) 548-5000 | Legacy Community Health Services, Inc 12540 Sugardale Dr Stafford TX 77477-3702 Ph: (832) 548-5000 |
| NPI Number | 1407516677 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 01/08/2025 |
| Certification Date | 01/08/2025 |
| Medicare PECOS PAC ID | 7911969092 |
|---|---|
| Medicare Enrollment ID | O20220414001164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407516677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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