Provider Demographics
NPI:1104840016
Name:LEE, DAVID ANSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANSON
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 1:6400 FANNIN ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-9400
Mailing Address - Fax:713-486-9595
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:SUITE 1800
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-486-9400
Practice Address - Fax:713-486-9595
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6721207W00000X, 207WX0009X
SC23521207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188911501Medicaid
TXM6721OtherTEXAS LICENSE NUMBER
TX188911503Medicaid