Provider Demographics
NPI:1023177219
Name:LE, OLIVIA THUY (OD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:THUY
Last Name:LE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 FM 2181 STE 230-113
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4219
Mailing Address - Country:US
Mailing Address - Phone:940-497-3937
Mailing Address - Fax:
Practice Address - Street 1:4251 FM 2181 STE 230-113
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-4219
Practice Address - Country:US
Practice Address - Phone:940-497-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5871TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist