Provider Demographics
NPI:1316376973
Name:LE, PHUONG THUY (PHARM D)
Entity Type:Individual
Prefix:
First Name:PHUONG
Middle Name:THUY
Last Name:LE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 JOYCELYN DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-7510
Mailing Address - Country:US
Mailing Address - Phone:504-236-3695
Mailing Address - Fax:
Practice Address - Street 1:9701 CHEF MENTEUR HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-4235
Practice Address - Country:US
Practice Address - Phone:504-245-0064
Practice Address - Fax:504-245-3777
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist