MEDICARE: DR. ERNEST CASTRO LEE M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E-1434	OK
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	E-1434	OK

General Provider Information

NPI Number	:	1013906718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST CASTRO LEE M.D., M.P.H.

Provider Business Mailing Address
First Line	:	17123 APPLE TREE DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-6893
Country	:	US
Telephone Number	:	405-734-3401
Fax Number	:	405-734-3404

Provider Business Practice Location Address
First Line	:	8941 ENTRANCE RD A
Second Line	:	72 AMDS/SGPO
City	:	TINKER AFB
State	:	OK
Zip	:	73145-3065
Country	:	US
Telephone Number	:	405-734-3401
Fax Number	:	405-734-3404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	09/11/2025

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