Provider Demographics
NPI:1518562297
Name:LE, THAOVY NGUYEN
Entity Type:Individual
Prefix:
First Name:THAOVY
Middle Name:NGUYEN
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 1:4101 FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3301
Mailing Address - Country:US
Mailing Address - Phone:281-998-2303
Mailing Address - Fax:281-998-2318
Practice Address - Street 1:4101 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3301
Practice Address - Country:US
Practice Address - Phone:281-998-2303
Practice Address - Fax:281-998-2318
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist