Provider Demographics
NPI:1225229651
Name:TRU VAN LE M.D., P.C.
Entity type:Organization
Organization Name:TRU VAN LE M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRU
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-241-5695
Mailing Address - Street 1:6404 SEVEN CORNERS PL STE F
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2033
Mailing Address - Country:US
Mailing Address - Phone:703-241-5695
Mailing Address - Fax:702-237-9896
Practice Address - Street 1:6404 SEVEN CORNERS PL STE F
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2033
Practice Address - Country:US
Practice Address - Phone:703-241-5695
Practice Address - Fax:703-237-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA21540001OtherCAREFIRST BCBS
VA281005OtherAMERIGROUP
VA201878OtherANTHEM BCBS
VA201878OtherANTHEM HEALTHKEEPER PLUS
VA6731881Medicaid