Provider Demographics
NPI:1770796153
Name:LE, LAN KRISTIE THIEN (MD)
Entity type:Individual
Prefix:DR
First Name:LAN KRISTIE
Middle Name:THIEN
Last Name:LE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2985 S STATE HIGHWAY 360
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7615
Mailing Address - Country:US
Mailing Address - Phone:972-602-1166
Mailing Address - Fax:
Practice Address - Street 1:2985 S STATE HIGHWAY 360
Practice Address - Street 2:SUITE 140
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7615
Practice Address - Country:US
Practice Address - Phone:972-602-1166
Practice Address - Fax:972-602-1160
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2011-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN3133208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics