Provider Demographics
NPI:1902913825
Name:LE, HUNG H
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:H
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 ROGERDALE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-1659
Mailing Address - Country:US
Mailing Address - Phone:713-772-2020
Mailing Address - Fax:713-772-2015
Practice Address - Street 1:6002 ROGERDALE RD STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-1659
Practice Address - Country:US
Practice Address - Phone:713-772-2020
Practice Address - Fax:713-772-2015
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4292207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144192501Medicaid
TX144192501Medicaid