Healthcare Provider Details

I. General information

NPI: 1962603126
Provider Name (Legal Business Name): MAI LE SOMPHET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAI LE DINH M.D.

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9436 N HOUSTON ROSSLYN RD STE C
HOUSTON TX
77088-3905
US

IV. Provider business mailing address

9235 KATY FWY STE 400
HOUSTON TX
77024-1507
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax: 713-461-5307
Mailing address:
  • Phone: 713-461-2915
  • Fax: 713-461-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRESIDENT
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01068002A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-15699
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN7693
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: