Provider Demographics
NPI:1699806018
Name:LEGACY SURGERY CENTER OF FRISCO LP
Entity Type:Organization
Organization Name:LEGACY SURGERY CENTER OF FRISCO LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:BUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-612-7131
Mailing Address - Street 1:5616 WARREN PARKWAY
Mailing Address - Street 2:SUITE 100 & 100A
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-712-4800
Mailing Address - Fax:972-712-4808
Practice Address - Street 1:5616 WARREN PARKWAY
Practice Address - Street 2:SUITE 100 & 100A
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-712-4800
Practice Address - Fax:972-712-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical