Provider Demographics
NPI:1003808163
Name:LE, NHI P (MD)
Entity Type:Individual
Prefix:
First Name:NHI
Middle Name:P
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NHI
Other - Middle Name:P
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:307 CALHOUN PLZ
Mailing Address - Street 2:
Mailing Address - City:PORT LAVACA
Mailing Address - State:TX
Mailing Address - Zip Code:77979-2421
Mailing Address - Country:US
Mailing Address - Phone:361-551-2288
Mailing Address - Fax:361-551-2338
Practice Address - Street 1:307 CALHOUN PLZ
Practice Address - Street 2:
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-2421
Practice Address - Country:US
Practice Address - Phone:361-551-2288
Practice Address - Fax:361-551-2338
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9105207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX943417821OtherTAX ID
TX030189902Medicaid
TX110202064OtherRAIL ROAD MEDICARE
TX8AD895OtherBC/BS
TX0060466OtherBLUE LINK
TX7160045OtherAETNA
TX030819901Medicaid
TX110202064OtherRAIL ROAD MEDICARE
TXTXB101621Medicare PIN