Provider Demographics
NPI:1205848033
Name:LE, TRI MINH (MD)
Entity Type:Individual
Prefix:DR
First Name:TRI
Middle Name:MINH
Last Name:LE
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:PO BOX 1293
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-1293
Mailing Address - Country:US
Mailing Address - Phone:281-774-8785
Mailing Address - Fax:832-543-5006
Practice Address - Street 1:21 ALPINE ST
Practice Address - Street 2:
Practice Address - City:COLDSPRING
Practice Address - State:TX
Practice Address - Zip Code:77331-8058
Practice Address - Country:US
Practice Address - Phone:936-647-2227
Practice Address - Fax:936-647-2202
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5810207Q00000X, 207Q00000X
ALMD.27200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186135302Medicaid
TX7347904OtherAETNA
TX8X8930OtherBLUE CROSS
TX186135311Medicaid
TX8U9123OtherBLUE CROSS
TX186135309Medicaid
TX186135302Medicaid
TX186135309Medicaid
TX311524YM9KMedicare PIN
TX8X8930OtherBLUE CROSS