MEDICARE: TERRY LEE DDS PLLC

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	122300000X	Dentist	23354	TX

General Provider Information

NPI Number	:	1407125685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRY LEE DDS PLLC

Provider Business Mailing Address
First Line	:	3800 N SHEPHERD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6400
Country	:	US
Telephone Number	:	813-802-0011
Fax Number	:	713-422-2457

Provider Business Practice Location Address
First Line	:	3800 N SHEPHERD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6400
Country	:	US
Telephone Number	:	813-802-0011
Fax Number	:	713-422-2457

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TERRY LEE
Credential	:	DDS
Telephone Number	:	713-802-0011

Provider Enumeration Date	:	12/18/2011
Last Update Date	:	12/18/2011

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