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General NPI Number Information
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NPI Number | 1316831605
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Entity Type | Individual
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Provider Name | MR. MIN JAE LEE
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Gender | Male
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 16655 SOUTHWEST FWY
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City | SUGAR LAND
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State | TX
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Zip | 77479-2329
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Country | US
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Telephone | 281-274-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 15000 W AIRPORT BLVD APT 433
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City | SUGAR LAND
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State | TX
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Zip | 77498-7248
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Country | US
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Telephone | 308-520-8748
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1194760
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License Number State | TX
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