1558567669 NPI number — THOMAS TRONG LE, M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558567669 NPI number — THOMAS TRONG LE, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS TRONG LE, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558567669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6918 CORPORATE DR
Provider Second Line Business Mailing Address:
SUITE A-12
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77036-5112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-995-8600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6918 CORPORATE DR
Provider Second Line Business Practice Location Address:
SUITE A-12
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-5112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-995-8600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LE
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
TRONG
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-995-8600

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  H9365 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10021550 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8284911 . This is a "CIGNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1351884-07 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0004478804 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 107609203764 . This is a "HUMANA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2256333 . This is a "EATNA HEALTH MAMAGEMENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0-04504 . This is a "EVERCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 02803 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1508877259 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1558567669 . This is a "MEDICARE PART B" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 3551 . This is a "MHHNP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 345866 . This is a "HEALTH MARKET" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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