MEDICARE: CHRISTINE M LEE PMHNP-BC, FNP-BC

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	363L00000X	Nurse Practitioner	AP138938	TX
2	363LF0000X	Family Nurse Practitioner	AP138938	TX
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP138938	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP138938	OTHER	TX	TEXAS MEDICAL LICENSE

General Provider Information

NPI Number	:	1609331529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE M LEE PMHNP-BC, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 208354
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-8354
Country	:	US
Telephone Number	:	512-485-7208
Fax Number	:	844-364-8678

Provider Business Practice Location Address
First Line	:	205 WOODHEW DR STE 203
Second Line	:
City	:	WOODWAY
State	:	TX
Zip	:	76712-6679
Country	:	US
Telephone Number	:	254-732-6632
Fax Number	:	254-732-0947

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

Provider Enumeration Date	:	02/05/2019
Last Update Date	:	08/06/2025

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