Provider Demographics
NPI:1073578035
Name:LEE, PAUL M (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75403-0432
Mailing Address - Country:US
Mailing Address - Phone:903-454-1700
Mailing Address - Fax:903-454-1701
Practice Address - Street 1:2904 STERLING HART DR
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3912
Practice Address - Country:US
Practice Address - Phone:903-886-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ21532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080020301Medicaid
TXF62306Medicare UPIN
TX89060NMedicare ID - Type Unspecified