Provider Demographics
NPI:1083219968
Name:LE, TRI-DUNG THANH
Entity Type:Individual
Prefix:DR
First Name:TRI-DUNG
Middle Name:THANH
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4123
Mailing Address - Country:US
Mailing Address - Phone:281-528-2810
Mailing Address - Fax:281-528-2816
Practice Address - Street 1:3850 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4123
Practice Address - Country:US
Practice Address - Phone:281-528-2810
Practice Address - Fax:281-528-2816
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist