Provider Demographics
NPI:1396357646
Name:LE, HIEN T
Entity Type:Individual
Prefix:
First Name:HIEN
Middle Name:T
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 LAS VEGAS BLVD N
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5756
Mailing Address - Country:US
Mailing Address - Phone:702-642-5318
Mailing Address - Fax:702-657-6985
Practice Address - Street 1:3030 LAS VEGAS BLVD N
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5756
Practice Address - Country:US
Practice Address - Phone:702-642-5318
Practice Address - Fax:702-657-6985
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist