Individual
DR. CUC KIM T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5959 LONG PRAIRIE ROAD, FLOWER MOUND, TX 75028
(214) 513-8039
(972) 874-6719
Mailing address
9529 S KILDARE AVE, OAK LAWN, IL 60453-3222
(708) 717-9523
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010315
IL
152W00000X
Optometrist
Primary
7923T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
579250097
MEDICARE PTAN
IL
01
—
579270084
MEDICARE PTAN
IL
Enumeration date
03/29/2010
Last updated
10/15/2012
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