MEDICARE: THUY MONGVIET LE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	31631	TX

General Provider Information

NPI Number	:	1033741954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUY MONGVIET LE

Provider Business Mailing Address
First Line	:	1938 W GRAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4816
Country	:	US
Telephone Number	:	713-521-2317
Fax Number	:	713-521-2346

Provider Business Practice Location Address
First Line	:	1938 W GRAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4816
Country	:	US
Telephone Number	:	713-521-2317
Fax Number	:	713-521-2346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2020
Last Update Date	:	02/08/2020

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Directions to “ THUY MONGVIET LE ” Practice Location

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