NPI 1366838658

Legacy Physiatry Group Missouri, LLC

Organisation Physical Medicine & Rehabilitation Physician Saint Louis, MO

Practice location

Address: 3636 S Geyer Rd 100, Saint Louis, MO 63127-1237
Phone: (972) 372-1663
Mailing address: 850 Central Pkwy E, Plano, TX 75074-5561

Authorised official

Name: Vivek Sastry
Title: President/Ceo
Phone: (972) 372-1663

Registered specialties (4)

Physical Medicine & Rehabilitation Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208100000X

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Internal Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207R00000X

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

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Registry record

NPI: 1366838658
Entity type: Organization
NPI issued: 13 Apr 2015
Record last updated: 13 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.