MEDICARE: DR. GRACE LEE D.O.

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	207Q00000X	Family Medicine Physician	R6601	TX

General Provider Information

NPI Number	:	1932580743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRACE LEE D.O.

Provider Business Mailing Address
First Line	:	10107 LOUETTA RD STE 106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1574
Country	:	US
Telephone Number	:	832-241-8004
Fax Number	:	833-973-5653

Provider Business Practice Location Address
First Line	:	10107 LOUETTA RD STE 106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1574
Country	:	US
Telephone Number	:	832-241-8004
Fax Number	:	833-973-5653

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

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	01/21/2025

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Directions to “ DR. GRACE LEE D.O.” Practice Location

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