MEDICARE: JONG HWA LEE

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	174400000X	Specialist	L2406	TX

General Provider Information

NPI Number	:	1144418450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONG HWA LEE

Provider Business Mailing Address
First Line	:	4325 N JOSEY LN
Second Line	:	SUITE 305
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4638
Country	:	US
Telephone Number	:	972-395-7131
Fax Number	:	972-395-7585

Provider Business Practice Location Address
First Line	:	4325 N JOSEY LN
Second Line	:	SUITE 305
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4638
Country	:	US
Telephone Number	:	972-395-7131
Fax Number	:	972-395-7585

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JONG HWA LEE
Credential	:	M.D., PHD
Telephone Number	:	972-395-7131

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	11/07/2007

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Directions to “JONG HWA LEE ” Practice Location

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