Provider Demographics
NPI:1205286010
Name:LE, THUY MONG (OD)
Entity type:Individual
Prefix:DR
First Name:THUY
Middle Name:MONG
Last Name:LE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 N POINT PKWY STE 72
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1146
Mailing Address - Country:US
Mailing Address - Phone:770-410-1540
Mailing Address - Fax:770-410-7525
Practice Address - Street 1:5755 N POINT PKWY STE 72
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1146
Practice Address - Country:US
Practice Address - Phone:770-410-1540
Practice Address - Fax:770-410-7525
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002941152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist