Healthcare Provider Details

I. General information

NPI: 1992651426
Provider Name (Legal Business Name): MAI TUYET LE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3175 SAINT ROSE PKWY STE 121
HENDERSON NV
89052-3507
US

IV. Provider business mailing address

3175 SAINT ROSE PKWY STE 121
HENDERSON NV
89052-3507
US

V. Phone/Fax

Practice location:
  • Phone: 702-802-5100
  • Fax: 702-202-1066
Mailing address:
  • Phone: 702-802-5100
  • Fax: 702-202-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0786
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: