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General NPI Number Information
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NPI Number | 1356146336
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Entity Type | Individual
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Provider Name | PHU BA LE FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 7201 WYOMING SPG DR STE 400
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City | ROUND ROCK
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State | TX
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Zip | 78681-4311
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Country | US
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Telephone | 855-876-7246
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Fax | 855-277-5070
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Provider Business Mailing Address
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Address Line | PO BOX 208357
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City | DALLAS
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State | TX
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Zip | 75320-8357
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Country | US
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Telephone | 512-485-7208
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Fax | 737-304-0942
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1176303
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License Number State | TX
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