Provider Demographics
NPI:1053460865
Name:LEE, SHAYNA PATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:PATRICE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3448 BINZ ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7816
Mailing Address - Country:US
Mailing Address - Phone:713-557-4968
Mailing Address - Fax:713-527-9696
Practice Address - Street 1:12805 CULLEN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3737
Practice Address - Country:US
Practice Address - Phone:713-738-6955
Practice Address - Fax:713-738-6690
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH05542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G8ITMedicare ID - Type Unspecified