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NPI Code Detail

MEDICARE: THUONG LE

MEDICARE: THUONG 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
1152W00000XOptometrist7277TGTX

General Provider Information

NPI Number : 1104268770
Entity Type Code : Organization
Provider Name (Legal Business Name) : THUONG LE
Provider Business Mailing Address
First Line : 1815 BROTHERS BLVD
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-5413
Country : US
Telephone Number : 979-695-3937
Fax Number : 979-695-3938
Provider Business Practice Location Address
First Line : 1815 BROTHERS BLVD
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-5413
Country : US
Telephone Number : 979-695-3937
Fax Number : 979-695-3938
Authorized Official
Title or Position : OWNER
Name : THUONG LE
Credential : O.D.
Telephone Number : 979-695-3937
Provider Enumeration Date : 07/24/2013
Last Update Date : 07/24/2013

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Directions to “THUONG LE ” Practice Location

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