Provider Demographics
NPI:1841506789
Name:LEGACY PSYCHIATRIC CONSULTANTS, PLLC
Entity type:Organization
Organization Name:LEGACY PSYCHIATRIC CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:CRUMPACKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-403-1463
Mailing Address - Street 1:5045 LORIMAR DR STE 290
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5721
Mailing Address - Country:US
Mailing Address - Phone:972-403-1463
Mailing Address - Fax:972-403-1465
Practice Address - Street 1:5045 LORIMAR DR STE 290
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5721
Practice Address - Country:US
Practice Address - Phone:972-403-1463
Practice Address - Fax:972-403-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ89772084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty