MEDICARE: HUNG LE M.D.

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	207R00000X	Internal Medicine Physician	2016018395	MO

General Provider Information

NPI Number	:	1174973978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUNG LE M.D.

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-362-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9509 N BEACH ST STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6399
Country	:	US
Telephone Number	:	817-617-8600
Fax Number	:

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

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	06/17/2019

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