MEDICARE: DR. JOHN LEE M.D.

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	2085R0202X	Diagnostic Radiology Physician	K9834	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00339659	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1578544607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LEE M.D.

Provider Business Mailing Address
First Line	:	9440 BELLAIRE BLVD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4558
Country	:	US
Telephone Number	:	832-239-8536
Fax Number	:	713-490-3139

Provider Business Practice Location Address
First Line	:	9440 BELLAIRE BLVD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4558
Country	:	US
Telephone Number	:	832-239-8536
Fax Number	:	713-490-3139

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/17/2016

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Directions to “ DR. JOHN LEE M.D.” Practice Location

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