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General NPI Number Information
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NPI Number | 1417161886
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Entity Type | Individual
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Provider Name | MICHAEL LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 8512 CADBURY CT
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City | PLANO
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State | TX
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Zip | 75024-6822
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Country | US
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Telephone | 708-829-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-1975
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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 | 48481
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License Number State | MN
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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 | 29762
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 206767
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License Number State | LA
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