MEDICARE: QUAN H LE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	K6478	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00337M	OTHER	TX	MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)

General Provider Information

NPI Number	:	1376725986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUAN H LE MD PA

Provider Business Mailing Address
First Line	:	8800 LONG POINT RD
Second Line	:	STE D
City	:	HOUSTON
State	:	TX
Zip	:	77055-3025
Country	:	US
Telephone Number	:	713-468-8889
Fax Number	:	713-468-1108

Provider Business Practice Location Address
First Line	:	8800 LONG POINT RD
Second Line	:	STE D
City	:	HOUSTON
State	:	TX
Zip	:	77055-3025
Country	:	US
Telephone Number	:	713-468-8889
Fax Number	:	713-468-1108

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. QUAN HUONG LE
Credential	:	M.D.
Telephone Number	:	713-468-8889

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	07/22/2008

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