MEDICARE: JAMES LEE DC

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	111N00000X	Chiropractor	11624	TX

General Provider Information

NPI Number	:	1881996791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES LEE DC

Provider Business Mailing Address
First Line	:	1823 FORTVIEW RD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7663
Country	:	US
Telephone Number	:	512-540-0231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1823 FORTVIEW RD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7663
Country	:	US
Telephone Number	:	512-540-0231
Fax Number	:

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

Provider Enumeration Date	:	11/29/2010
Last Update Date	:	09/12/2012

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Directions to “ JAMES LEE DC” Practice Location

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