MEDICARE: 1960 FAMILY PRACTICE, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	207X00000X	Orthopaedic Surgery Physician
5	207Y00000X	Otolaryngology Physician
6	208000000X	Pediatrics Physician
7	208100000X	Physical Medicine & Rehabilitation Physician
8	213E00000X	Podiatrist
9	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1184173221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1960 FAMILY PRACTICE, PA

Provider Business Mailing Address
First Line	:	20320 NORTHWEST FWY
Second Line	:	SUITE 900
City	:	JERSEY VILLAGE
State	:	TX
Zip	:	77065-5641
Country	:	US
Telephone Number	:	281-453-7232
Fax Number	:	281-440-2020

Provider Business Practice Location Address
First Line	:	3550 RAYFORD RD
Second Line	:	SUITE 110A
City	:	SPRING
State	:	TX
Zip	:	77386-4343
Country	:	US
Telephone Number	:	281-586-3888
Fax Number	:	281-440-2020

Authorized Official
Title or Position	:	OWNER
Name	:	HUONG T LE
Credential	:	MD
Telephone Number	:	281-586-3888

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	09/30/2016

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Directions to “1960 FAMILY PRACTICE, PA ” Practice Location

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