=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457308348
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY Y LEE, MDPA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2006
-----------------------------------------------------
Last Update Date | 08/23/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8495 LONG POINT RD 212
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77055-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-464-7212
-----------------------------------------------------
Fax | 713-464-7236
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8495 LONG POINT RD 212
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77055-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-464-7212
-----------------------------------------------------
Fax | 713-464-7236
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JEFFREY Y LEE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 713-464-7212
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------