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General NPI Number Information
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NPI Number | 1780383554
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Entity Type | Individual
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Provider Name | KENNY LEE MD
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Gender | Male
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | JBSA FT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-3290
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Fax |
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Provider Business Mailing Address
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Address Line | BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL UNIT 15245
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City | APO
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State | AP
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Zip | 96271
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 1780383554
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License Number State | WA
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