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General NPI Number Information
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NPI Number | 1144586140
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Entity Type | Organization
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Legal Business Name | MONICA LEE, NP, PC
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 8001 WESTERN HILLS BLVD
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City | FORT WORTH
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State | TX
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Zip | 76108-3524
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Country | US
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Telephone | 817-889-2609
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Fax | 817-719-9257
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Provider Business Mailing Address
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Address Line | 3836 HILLTOP RD
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City | FORT WORTH
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State | TX
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Zip | 76109-2715
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Country | US
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Telephone | 817-889-2609
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Fax | 817-889-2609
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Authorized Official
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Title or Position | CEO/NURSE PRACTITIONER
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Name | MONICA LEE
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Credential | NP-C
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Telephone | 817-889-2609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 682195
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License Number State | TX
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