MEDICARE: DR. VICTORIA T LE DC

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	111N00000X	Chiropractor	10534	TX

General Provider Information

NPI Number	:	1720281702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA T LE DC

Provider Business Mailing Address
First Line	:	1145 KINWEST PKWY
Second Line	:	200
City	:	IRVING
State	:	TX
Zip	:	75063-3516
Country	:	US
Telephone Number	:	972-506-8776
Fax Number	:	972-501-0083

Provider Business Practice Location Address
First Line	:	1145 KINWEST PKWY
Second Line	:	200
City	:	IRVING
State	:	TX
Zip	:	75063-3409
Country	:	US
Telephone Number	:	972-506-8776
Fax Number	:	972-501-0083

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	11/21/2016

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Directions to “ DR. VICTORIA T LE DC” Practice Location

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