MEDICARE: TRUNG NGUYEN LE M.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	207Q00000X	Family Medicine Physician	J7046	TX

General Provider Information

NPI Number	:	1659336931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRUNG NGUYEN LE M.D.

Provider Business Mailing Address
First Line	:	2410 ELLA BLVD
Second Line	:	STE. #A
City	:	HOUSTON
State	:	TX
Zip	:	77008-2710
Country	:	US
Telephone Number	:	713-426-6930
Fax Number	:	713-426-6983

Provider Business Practice Location Address
First Line	:	2410 ELLA BLVD
Second Line	:	STE. #A
City	:	HOUSTON
State	:	TX
Zip	:	77008-2710
Country	:	US
Telephone Number	:	713-426-6930
Fax Number	:	713-426-6983

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	01/07/2010

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