Provider Demographics
NPI:1205020708
Name:NGUYEN, LE THANH (MD)
Entity Type:Individual
Prefix:
First Name:LE
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 W. WALNUT ST
Mailing Address - Street 2:STE 225
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042
Mailing Address - Country:US
Mailing Address - Phone:972-272-7816
Mailing Address - Fax:972-276-8137
Practice Address - Street 1:3465 W. WALNUT ST
Practice Address - Street 2:STE 225
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042
Practice Address - Country:US
Practice Address - Phone:281-484-0449
Practice Address - Fax:281-484-7210
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM7473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine