Provider Demographics
NPI:1659880045
Name:LEGENDRE, EMILY (DC)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:LEGENDRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 NORWOOD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-5232
Mailing Address - Country:US
Mailing Address - Phone:817-717-9406
Mailing Address - Fax:817-697-4174
Practice Address - Street 1:1310 NORWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5232
Practice Address - Country:US
Practice Address - Phone:817-717-9406
Practice Address - Fax:817-697-4174
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty