Provider Demographics
NPI:1942341854
Name:LE, BRIAN THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:THOMAS
Last Name:LE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:THONG
Other - Middle Name:QUOC
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2410 FIRE MESA ST
Mailing Address - Street 2:#160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9016
Mailing Address - Country:US
Mailing Address - Phone:702-676-2000
Mailing Address - Fax:702-676-2042
Practice Address - Street 1:2410 FIRE MESA ST
Practice Address - Street 2:#160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9016
Practice Address - Country:US
Practice Address - Phone:702-676-2000
Practice Address - Fax:702-676-2042
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1524207LP2900X, 208VP0000X, 207L00000X, 207LA0401X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1598070914OtherGROUP NPI