MEDICARE: DAVID WOOSUK LEE MD

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	207R00000X	Internal Medicine Physician	A97378	CA
2	207R00000X	Internal Medicine Physician	M9444	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740402874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID WOOSUK LEE MD

Provider Business Mailing Address
First Line	:	902 W RANDOL MILL RD STE 250
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2584
Country	:	US
Telephone Number	:	817-417-9334
Fax Number	:	817-417-9339

Provider Business Practice Location Address
First Line	:	902 W RANDOL MILL RD STE 150
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-417-9334
Fax Number	:	817-417-9339

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	02/21/2022

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Directions to “ DAVID WOOSUK LEE MD” Practice Location

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