MEDICARE: DR. YVONNE DENISE LEE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8631T	TX
2	152W00000X	Optometrist	1179	AZ

General Provider Information

NPI Number	:	1144217035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE DENISE LEE O.D.

Provider Business Mailing Address
First Line	:	2445 E WILCOX DR
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-2842
Country	:	US
Telephone Number	:	520-458-8131
Fax Number	:	520-458-0422

Provider Business Practice Location Address
First Line	:	4116 AVENIDA COCHISE STE A
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-5824
Country	:	US
Telephone Number	:	520-452-1125
Fax Number	:	520-458-0422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	03/06/2025

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