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General NPI Number Information
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NPI Number | 1174678874
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD LE O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9665 FM 1960 W. BYPASS RD. STE. A
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City | HUMBLE
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State | TX
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Zip | 77338-4043
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Country | US
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Telephone | 281-548-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 923 MCKINNEY PARK LN
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City | HOUSTON
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State | TX
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Zip | 77003-3642
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Country | US
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Telephone | 713-223-5410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6749TG
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License Number State | TX
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