Basic Information
| Provider Information | |||||||||
| NPI: | 1083829568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | DUC | ||||||||
| MiddleName: | MINH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LE | ||||||||
| OtherFirstName: | STEVE | ||||||||
| OtherMiddleName: | MINH | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2820 COTSWOLD MANOR DR S | ||||||||
| Address2: | |||||||||
| City: | KINGWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773391656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815931500 | ||||||||
| FaxNumber: | 2815931509 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 E HOUSTON ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773274512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815931500 | ||||||||
| FaxNumber: | 2815931509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 12/08/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 57.008793 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | M8117 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.