Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | K9105 | TX |
N | 207R00000X | Internist | K9105 | TX |
N | 111NI0900X | Internist | K9105 | TX |
NPI | 1003808163 |
---|---|
Provider Name | Nhi P Le |
First Address | Port Lavaca, TX 77979-2421 |
Second Address | Port Lavaca, TX 77979-2421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 21/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0060466 | BLUE LINK (01) | TX |
030189902 | (05) | TX |
030819901 | (05) | TX |
110202064 | RAIL ROAD MEDICARE (01) | TX |
7160045 | AETNA (01) | TX |
8AD895 | BC/BS (01) | TX |
943417821 | TAX ID (01) | TX |
H03309 | (02) | TX |