Individual provider Active NPI

Giao Quynh Le, PHARM.D

  • Pharmacist
  • Pantego, TX
National Provider Identifier
1124628318
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
47281 Issued in TX
Practice address
2610 W Pioneer Pkwy
Pantego, TX 76013-5904
Phone
(817) 303-4302
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.018630 LA
Pharmacist 183500000X 47281 TX Primary

Addresses

Primary practice location

2610 W Pioneer Pkwy
Pantego, TX 76013-5904

Mailing address

4508 Seventeen Lakes CT
Roanoke, TX 76262-3741

Other identifiers 1

IdentifierTypeStateIssuer
469697MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gle.s03594@us.wal-mart.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PST.018630LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores Texas LLC PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1124628318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 SEVENTEEN LAKES CT",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 W PIONEER PKWY",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760135904",
            "telephone_number": "817-303-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "GIAO",
        "middle_name": "QUYNH",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.018630",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "47281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469697",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gle.s03594@us.wal-mart.com",
            "affiliation": "N",
            "address_1": "2610 W Pioneer Pkwy",
            "city": "Pantego",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760135904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pantego, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.