MEDICARE: DR. KRISTINE LE PHARM.D.

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	183500000X	Pharmacist	56286	TX

General Provider Information

NPI Number	:	1518560960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINE LE PHARM.D.

Provider Business Mailing Address
First Line	:	PO BOX 37376
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77237-7376
Country	:	US
Telephone Number	:	702-806-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 ELDRIDGE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-6870
Country	:	US
Telephone Number	:	281-810-5252
Fax Number	:	281-810-5262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	11/18/2020

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