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General NPI Number Information
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NPI Number | 1356803852
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Entity Type | Individual
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Provider Name | YITZHAK LEE DO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 5926 W NW HWY
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City | DALLAS
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State | TX
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Zip | 75225-3202
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 900 8TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-3902
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22855
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License Number State | CA
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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 | T3323
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License Number State | TX
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