Provider Demographics
NPI:1336502749
Name:LE, MINH-DA
Entity Type:Individual
Prefix:
First Name:MINH-DA
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MINHDA
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3417 GASTON AVE STE 980
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2022
Mailing Address - Country:US
Mailing Address - Phone:469-800-8020
Mailing Address - Fax:469-800-8030
Practice Address - Street 1:3417 GASTON AVE STE 980
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2022
Practice Address - Country:US
Practice Address - Phone:469-800-8020
Practice Address - Fax:469-800-8030
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5157207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism