Provider Demographics
NPI:1952518656
Name:LE, NAM HOAI (MD)
Entity Type:Individual
Prefix:
First Name:NAM
Middle Name:HOAI
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1105 CENTRAL EXPY N STE 2370
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6103
Mailing Address - Country:US
Mailing Address - Phone:972-747-4271
Mailing Address - Fax:972-747-4272
Practice Address - Street 1:1105 CENTRAL EXPY N STE 2370
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6103
Practice Address - Country:US
Practice Address - Phone:972-747-4271
Practice Address - Fax:972-747-4272
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050183672086S0122X
TXN85352086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB136200Medicare PIN
TXTXB136199Medicare PIN
TXTXB136201Medicare PIN