MEDICARE: MRS. MARY-ELIZABETH AFIA BANIEH-LEE

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	183500000X	Pharmacist	39058	TX

General Provider Information

NPI Number	:	1487376778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY-ELIZABETH AFIA BANIEH-LEE

Provider Business Mailing Address
First Line	:	5204 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-7502
Country	:	US
Telephone Number	:	713-961-0874
Fax Number	:	713-961-0874

Provider Business Practice Location Address
First Line	:	5204 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-7502
Country	:	US
Telephone Number	:	713-961-0874
Fax Number	:	713-961-0874

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

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/14/2022

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