Provider Demographics
NPI:1538459193
Name:LE, THANH-THAO THI (MD)
Entity Type:Individual
Prefix:
First Name:THANH-THAO
Middle Name:THI
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR STE 1.100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:10907 MEMORIAL HERMANN DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4114
Practice Address - Country:US
Practice Address - Phone:713-413-6610
Practice Address - Fax:281-316-0886
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33898207Q00000X
LA310933207Q00000X
MO2018015469207Q00000X
WY9523A207Q00000X
ARE-11480207Q00000X
TXQ7408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine