Provider Demographics
NPI:1669660304
Name:DON N LE DDS PA
Entity Type:Organization
Organization Name:DON N LE DDS PA
Other - Org Name:CENTRO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:N
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:713-468-2488
Mailing Address - Street 1:8635 LONG POINT RD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3001
Mailing Address - Country:US
Mailing Address - Phone:713-468-2488
Mailing Address - Fax:713-468-1299
Practice Address - Street 1:8635 LONG POINT RD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3001
Practice Address - Country:US
Practice Address - Phone:713-468-2488
Practice Address - Fax:713-468-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193961223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009459103Medicaid
TX009459105Medicaid
TX177548801Medicaid
TX346840701Medicaid