Provider Demographics
NPI:1174678874
Name:LE, MICHAEL EDWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:LE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 MCKINNEY PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-3642
Mailing Address - Country:US
Mailing Address - Phone:713-223-5410
Mailing Address - Fax:
Practice Address - Street 1:9665 FM 1960 W. BYPASS RD.
Practice Address - Street 2:STE. A
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4043
Practice Address - Country:US
Practice Address - Phone:281-548-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6749TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist