Provider Demographics
NPI:1194112417
Name:LE, THANH-TRUC (MD)
Entity type:Individual
Prefix:
First Name:THANH-TRUC
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21212 NORTHWEST FWY STE 245
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5885
Mailing Address - Country:US
Mailing Address - Phone:281-955-0262
Mailing Address - Fax:281-955-0298
Practice Address - Street 1:21212 NORTHWEST FWY STE 245
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5885
Practice Address - Country:US
Practice Address - Phone:281-955-0262
Practice Address - Fax:281-955-0298
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47394207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty