Provider Demographics
NPI:1871836411
Name:LEGATO ANESTHESIA, INC
Entity Type:Organization
Organization Name:LEGATO ANESTHESIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:248-506-3584
Mailing Address - Street 1:PO BOX 4157
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-4157
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4519 N GARFIELD ST
Practice Address - Street 2:SUITE 15
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-3415
Practice Address - Country:US
Practice Address - Phone:432-699-0225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652148367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty