Individual
DR. ANDRE T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
116 E ELLISON ST STE C, BURLESON, TX 76028-4286
(817) 295-9696
(817) 295-9313
Mailing address
116 E ELLISON ST STE C, BURLESON, TX 76028-4286
(214) 998-0934
(817) 295-9313
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6555TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177117201
—
TX
01
—
8F0158
MEDICARE PROVIDER NUMBER
TX
01
—
TX6555TG
OD LICENSE
TX
Enumeration date
05/19/2006
Last updated
09/02/2022
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