Provider Demographics
NPI:1629203724
Name:LE, MINH QUANG (DO)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:QUANG
Last Name:LE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6507 S COOPER ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5817
Mailing Address - Country:US
Mailing Address - Phone:817-466-9100
Mailing Address - Fax:817-466-9410
Practice Address - Street 1:6507 S COOPER ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5817
Practice Address - Country:US
Practice Address - Phone:817-466-9100
Practice Address - Fax:817-466-9410
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN7713207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301874902Medicaid
TX8DE832OtherBLUE CROSS
TX286565YL8LMedicare PIN