Lan Le, DO, P.a.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

N2163 Issued in TX

Legal business name

LAN LE, DO, P.A.

Practice address

5632 Edwards Ranch Rd Ste 100
Fort Worth, TX 76109-4149

Phone

(817) 336-7188

Fax

(844) 231-8865

NPI assigned

Jun 4, 2009

Organization subpart

No

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

Authorized official

Name

Lan T Le, D.O.NPI 1417166240

Title

President

Phone

(817) 336-7188

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lan Thanh Le, DO

  • Physical Medicine & Rehabilitation Physician
  • Fort Worth, TX
  • NPI 1417166240
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1861628844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 678610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678610",
            "telephone_number": "817-336-7188",
            "fax_number": "817-335-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 EDWARDS RANCH RD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094149",
            "telephone_number": "817-336-7188",
            "fax_number": "844-231-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAN LE, DO, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "LAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-336-7188",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "N2163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205978401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0016SV",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Lamont
• Vivianna Lampkin
• Donna Maria Lampley Carriere, SLP
• Angela Lampley, CNM/WHNP
• Cassandra Lamptey, MS
• Katherine A Lancarte, SLP
• Ashley Lancaster
• Deborah Lynn Lancaster, PTA
• Kamie Lancaster, OT
• Christian Ann Lance, M.D.

• Physical Medicine & Rehabilitation Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.