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NPI Code Detail

MEDICARE: HUE T. LY DMD

MEDICARE: HUE T. LY DMD
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
1122300000XDentist32751TX
2122300000XDentistDL11557MA

General Provider Information

NPI Number : 1134483381
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUE T. LY DMD
Provider Business Mailing Address
First Line : 12125 HIGHWAY 6 STE D
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 281-431-8909
Fax Number :
Provider Business Practice Location Address
First Line : 12125 HIGHWAY 6 STE D
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 281-431-8909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2012
Last Update Date : 11/30/2022

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