Provider Demographics
NPI:1205805397
Name:LE, ROBERT D (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:LE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:D
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:13879 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3533
Mailing Address - Country:US
Mailing Address - Phone:281-277-3100
Mailing Address - Fax:281-277-3115
Practice Address - Street 1:13879 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3533
Practice Address - Country:US
Practice Address - Phone:281-277-3100
Practice Address - Fax:281-277-3115
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04995TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX04995TGOtherOPTOMETRY LICENSE
TXU65315Medicare UPIN
TX8C0876Medicare PIN