Basic Information
| Provider Information | |||||||||
| NPI: | 1538459193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | THANH-THAO | ||||||||
| MiddleName: | THI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 FROSTWOOD DR STE 1.100 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133384523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19419 GULF FWY STE 3 | ||||||||
| Address2: | |||||||||
| City: | WEBSTER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813160885 | ||||||||
| FaxNumber: | 2813160886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2011 | ||||||||
| LastUpdateDate: | 08/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 9523A | WY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2018015469 | MO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | E-11480 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 33898 | OK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 310933 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | Q7408 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.