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Organization
LEVI LE DDS
Active
Organization
LEVI LE DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEVI THI LE DDS (OWNER)
(979) 297-7369
Entity
Organization
Contact information
Practice address
101 B PARKING WAY, LAKE JACKSON, TX 77566
(979) 297-9838
Mailing address
101 B PARKING WAY, LAKE JACKSON, TX 77566
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15180
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G 60079-01
TEXAS CHIPS
TX
Enumeration date
05/20/2008
Last updated
05/20/2008
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