Provider Demographics
NPI:1144418450
Name:JONG HWA LEE
Entity Type:Organization
Organization Name:JONG HWA LEE
Other - Org Name:LEE EYE SURGERY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONG
Authorized Official - Middle Name:HWA
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:972-395-7131
Mailing Address - Street 1:4325 N JOSEY LN
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4638
Mailing Address - Country:US
Mailing Address - Phone:972-395-7131
Mailing Address - Fax:972-395-7585
Practice Address - Street 1:4325 N JOSEY LN
Practice Address - Street 2:SUITE 305
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4638
Practice Address - Country:US
Practice Address - Phone:972-395-7131
Practice Address - Fax:972-395-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2406174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00328VMedicare PIN