Provider Demographics
NPI:1013948900
Name:LE, THANG D (MD)
Entity Type:Individual
Prefix:
First Name:THANG
Middle Name:D
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W RANDOL MILL RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2504
Mailing Address - Country:US
Mailing Address - Phone:866-202-1032
Mailing Address - Fax:817-548-6649
Practice Address - Street 1:800 W RANDOL MILL RD STE 2300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2504
Practice Address - Country:US
Practice Address - Phone:866-202-1032
Practice Address - Fax:817-548-6649
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5173207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115569907Medicaid
TX8F6180OtherBC/BS
TX115569905Medicaid
TX115569906Medicaid
TX115569904Medicaid
TX115569904Medicaid
TX115569905Medicaid
TX8F6180OtherBC/BS
TXP00061321Medicare PIN
TXF93819Medicare UPIN
TX115569907Medicaid