Healthcare Provider Details

I. General information

NPI: 1326047465
Provider Name (Legal Business Name): LEE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E MAIN ST
HAMILTON TX
76531-1954
US

IV. Provider business mailing address

PO BOX 766
HAMILTON TX
76531-0766
US

V. Phone/Fax

Practice location:
  • Phone: 254-386-8971
  • Fax:
Mailing address:
  • Phone: 254-386-8971
  • Fax: 254-386-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number002197
License Number StateTX

VIII. Authorized Official

Name: PAMELA PARSONS
Title or Position: ADMINISTRATOR
Credential:
Phone: 254-386-8971