Provider Demographics
NPI:1942908843
Name:E&C LEGACY GROUP, INC.
Entity Type:Organization
Organization Name:E&C LEGACY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-721-1510
Mailing Address - Street 1:24165 IH10 WEST
Mailing Address - Street 2:SUITE 217 NUM 754
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257
Mailing Address - Country:US
Mailing Address - Phone:210-721-1510
Mailing Address - Fax:
Practice Address - Street 1:6222 DE ZAVALA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2275
Practice Address - Country:US
Practice Address - Phone:210-200-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy