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General NPI Number Information
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NPI Number | 1174014245
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Entity Type | Organization
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Legal Business Name | SONGLEE, PLLC
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 9202 BARKER CYPRESS RD STE 115
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City | CYPRESS
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State | TX
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Zip | 77433
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Country | US
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Telephone | 832-800-1550
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Fax |
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Provider Business Mailing Address
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Address Line | 9202 BARKER CYPRESS RD STE 115
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City | CYPRESS
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State | TX
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Zip | 77433-8201
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Country | US
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Telephone | 281-861-0440
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Fax | 281-861-0110
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RYULEE SONG
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Credential | DMD
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Telephone | 832-800-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33397
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32449
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License Number State | TX
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