MEDICARE: G. LEE AND ASSOCIATES, P.C.

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	101YP2500X	Professional Counselor	15331	TX

General Provider Information

NPI Number	:	1144417932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G. LEE AND ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	2616 S LOOP W STE 415
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2769
Country	:	US
Telephone Number	:	713-664-6777
Fax Number	:	713-664-6888

Provider Business Practice Location Address
First Line	:	2616 S LOOP W STE 415
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2769
Country	:	US
Telephone Number	:	713-664-6777
Fax Number	:	713-664-6888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GERALD EUGENE LEE
Credential	:	LPC
Telephone Number	:	713-664-6777

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	09/26/2007

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