Provider Demographics
NPI:1760632723
Name:LEGACY ANESTHESIA CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:LEGACY ANESTHESIA CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-237-6526
Mailing Address - Street 1:4275 LITTLE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-5600
Mailing Address - Country:US
Mailing Address - Phone:817-516-8811
Mailing Address - Fax:
Practice Address - Street 1:401 W CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3416
Practice Address - Country:US
Practice Address - Phone:814-516-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty