Provider Demographics
NPI:1700760337
Name:LEGGETT, HAYDEN SKEET
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:SKEET
Last Name:LEGGETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 HERITAGE TRACE PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-7505
Mailing Address - Country:US
Mailing Address - Phone:817-232-8632
Mailing Address - Fax:800-532-1769
Practice Address - Street 1:3451 HERITAGE TRACE PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-7505
Practice Address - Country:US
Practice Address - Phone:817-232-8632
Practice Address - Fax:800-532-1769
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292993183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician