Provider Demographics
NPI:1205936408
Name:LEGEND MEDQUIPMENT LLC
Entity type:Organization
Organization Name:LEGEND MEDQUIPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IFTIKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-776-0500
Mailing Address - Street 1:PO BOX 421671
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1671
Mailing Address - Country:US
Mailing Address - Phone:713-776-0500
Mailing Address - Fax:
Practice Address - Street 1:10101 BISSONNET ST
Practice Address - Street 2:SUIT 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7855
Practice Address - Country:US
Practice Address - Phone:713-776-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0046015332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016790001Medicaid
TX5810480001Medicare NSC
TX4404770001Medicare NSC