Provider Demographics
NPI:1073576864
Name:DAVID M LEE, MD, PA
Entity Type:Organization
Organization Name:DAVID M LEE, MD, PA
Other - Org Name:AHL MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-303-1033
Mailing Address - Street 1:2801 LEMMON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2399
Mailing Address - Country:US
Mailing Address - Phone:214-303-1033
Mailing Address - Fax:214-303-1032
Practice Address - Street 1:2801 LEMMON AVE STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2399
Practice Address - Country:US
Practice Address - Phone:214-303-1033
Practice Address - Fax:214-303-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173762901Medicaid
TX0006MQOtherBC/BS
TX00722YMedicare PIN
TX0006MQOtherBC/BS