MEDICARE: DR. BRIAN LEE, OPTOMETRY, PLLC

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	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558994814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. BRIAN LEE, OPTOMETRY, PLLC

Provider Business Mailing Address
First Line	:	3450 CYPRESS CREEK PKWY
Second Line	:	WALMART VISION
City	:	HOUSTON
State	:	TX
Zip	:	77068-3606
Country	:	US
Telephone Number	:	346-763-7392
Fax Number	:	585-385-7969

Provider Business Practice Location Address
First Line	:	3450 CYPRESS CREEK PKWY
Second Line	:	WALMART VISION
City	:	HOUSTON
State	:	TX
Zip	:	77068-3606
Country	:	US
Telephone Number	:	346-763-7392
Fax Number	:	585-385-7969

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DR. BRIAN LEE
Credential	:	OD
Telephone Number	:	346-763-7392

Provider Enumeration Date	:	02/14/2020
Last Update Date	:	02/28/2025

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