Healthcare Provider Details

I. General information

NPI: 1457074486
Provider Name (Legal Business Name): KATHY TUYEN LE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3426 CYPRESS ST STE 16
WEST MONROE LA
71291-7399
US

IV. Provider business mailing address

4207 LEON DR
ALEXANDRIA LA
71303-3444
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-0069
  • Fax: 318-396-3060
Mailing address:
  • Phone: 318-290-7947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.024562
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: