Provider Demographics
NPI:1649258757
Name:LE, TU KHAC (MD)
Entity type:Individual
Prefix:
First Name:TU KHAC
Middle Name:
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 1:1400 HOSPITAL PARKWAY, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6928
Mailing Address - Country:US
Mailing Address - Phone:817-545-4550
Mailing Address - Fax:
Practice Address - Street 1:1400 HOSPITAL PARKWAY, SUITE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6928
Practice Address - Country:US
Practice Address - Phone:817-545-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7003207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160809306Medicaid
TX8AX681OtherBCBS
TX160809306Medicaid
TXH91291Medicare UPIN
TXTXB147710Medicare PIN
TX8F8055Medicare PIN
TX8AX681OtherBCBS