Provider Demographics
NPI:1659866812
Name:LE, DEREK YIU-CHEUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:YIU-CHEUNG
Last Name:LE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24333 CINCO TERRACE DR APT 328
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1997
Mailing Address - Country:US
Mailing Address - Phone:832-439-1818
Mailing Address - Fax:
Practice Address - Street 1:17228 W GRAND PKWY S # 20
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3688
Practice Address - Country:US
Practice Address - Phone:281-342-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9525152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist