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NPI Code Detail

MEDICARE: NGA HOANG LE PHARM.D

MEDICARE: NGA HOANG LE PHARM.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
1183500000XPharmacist65180TX

General Provider Information

NPI Number : 1538704929
Entity Type Code : Individual
Provider Name (Legal Business Name) : NGA HOANG LE PHARM.D
Provider Business Mailing Address
First Line : 3425 SYCAMORE SCHOOL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-3030
Country : US
Telephone Number : 817-370-0505
Fax Number : 817-370-0077
Provider Business Practice Location Address
First Line : 3425 SYCAMORE SCHOOL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-3030
Country : US
Telephone Number : 817-370-0505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2019
Last Update Date : 11/09/2019

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