MEDICARE: DR. BORWEN PAUL LEE DDS

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	1223G0001X	General Practice Dentistry	22049	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22049	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1518030394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BORWEN PAUL LEE DDS

Provider Business Mailing Address
First Line	:	1717 SAINT JAMES PL
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77056-3404
Country	:	US
Telephone Number	:	713-621-4424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 SAINT JAMES PL
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77056-3404
Country	:	US
Telephone Number	:	713-621-4424
Fax Number	:	713-621-4430

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	06/23/2009

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