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Physician Compare National (NPI:1154315414)

HEALTHCARE PROVIDER: DI VAN LE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1154315414
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4587792452
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100513000620
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name LE
Individual professional last name
Provider First Name DI
Individual professional first name
Provider Middle Name VAN
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1964
Individual professional's medical school graduation year
Primary Specialty FAMILY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 DIAGNOSTIC RADIOLOGY
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties DIAGNOSTIC RADIOLOGY
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name SPECIALTY ASSOCIATES OF WEST HOUSTON, PLLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 6800056177
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 71
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1140 BUSINESS CTR DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 490
Group Practice or individual's line 2 address
City HOUSTON
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 770432741
Group Practice or individual's zip code (9 digits when available)
Phone Number 7139321247
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 450617
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 CLEAR LAKE REGIONAL MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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