Individual provider Active NPI

Lan Kristie Thien Le, M.D.

  • Pediatrics Physician
  • Grand Prairie, TX
National Provider Identifier
1770796153
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N3133 Issued in TX
Practice address
2985 S State Highway 360
Suite 140
Grand Prairie, TX 75052-7615
Phone
(972) 602-1166
Fax
(972) 602-1160
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N3133 TX Primary

Addresses

Primary practice location

2985 S State Highway 360
Suite 140
Grand Prairie, TX 75052-7615

Mailing address

2985 S State Highway 360
Suite 140
Grand Prairie, TX 75052-7615
Phone (972) 602-1166

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 Medicine

State licenses

LicenseStateTypeSpecialty
N3133TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Children'S Clinic, P.a. Pediatrics Past 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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1770796153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 S STATE HIGHWAY 360",
            "address_2": "SUITE 140",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527615",
            "telephone_number": "972-602-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 S STATE HIGHWAY 360",
            "address_2": "SUITE 140",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527615",
            "telephone_number": "972-602-1166",
            "fax_number": "972-602-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "LAN KRISTIE",
        "middle_name": "THIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.