| Doctor Name: | MISS MONG THAO TRISHA LE |
| NPI Number: | 1629490016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA200686 |
| Business Practice Address: | 7772 Highway 23 Ste A Belle Chasse, LA - 700372030 |
| Business Phone Number: | 5043719370 |
| Business Fax Number: | |
| Mailing Address: | 3817 Camphor St, HARVEY |
| State: | LA |
| Postal Code: | 700582440 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2014 |
| NPI Last Update Date: | 09/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA200686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |