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General NPI Number Information
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NPI Number | 1104803923
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Entity Type | Individual
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Provider Name | LEE W HAAK MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 5301 WILLIAM D TATE AVE
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City | GRAPEVINE
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State | TX
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Zip | 76051-7357
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Country | US
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Telephone | 817-251-2101
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Fax | 817-421-5041
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Provider Business Mailing Address
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Address Line | 110 E SAVANNAH AVE BLDG B SUITE 203
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City | MCALLEN
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State | TX
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Zip | 78503-9494
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Country | US
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Telephone | 956-686-7611
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Fax | 956-618-3164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | L2296
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2296
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License Number State | TX
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