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NPI Code Detail

MEDICARE: DR. PHI-NGA JEANNIE LE M.D.

MEDICARE: DR. PHI-NGA JEANNIE 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
1207PE0005XUndersea and Hyperbaric Medicine (Emergency Medicine) PhysicianM0144TX
2207P00000XEmergency Medicine PhysicianM0144TX
32083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) PhysicianM0144TX

General Provider Information

NPI Number : 1770568479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHI-NGA JEANNIE LE M.D.
Provider Business Mailing Address
First Line : PO BOX 650859 DEPT 710
Second Line :
City : DALLAS
State : TX
Zip : 75265
Country : US
Telephone Number : 409-772-0620
Fax Number :
Provider Business Practice Location Address
First Line : 2240 GULF FWY S
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-5143
Country : US
Telephone Number : 832-505-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 12/05/2022

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