Provider Demographics
NPI:1457074486
Name:LE, KATHY TUYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:TUYEN
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 LEON DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3444
Mailing Address - Country:US
Mailing Address - Phone:318-290-7947
Mailing Address - Fax:
Practice Address - Street 1:3426 CYPRESS ST STE 16
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7399
Practice Address - Country:US
Practice Address - Phone:318-396-0069
Practice Address - Fax:318-396-3060
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.024562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist