MEDICARE: COURTNEY 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	363A00000X	Physician Assistant	PA16676	TX

General Provider Information

NPI Number	:	1861817694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY LEE

Provider Business Mailing Address
First Line	:	2111 WESTHEIMER RD APT 2307
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1791
Country	:	US
Telephone Number	:	848-565-4990
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 FANNIN ST STE 1400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2613
Country	:	US
Telephone Number	:	832-824-8420
Fax Number	:

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

Provider Enumeration Date	:	03/04/2014
Last Update Date	:	07/31/2023

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Directions to “ COURTNEY LEE ” Practice Location

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