Provider Demographics
NPI:1225890924
Name:LEE, DONALD RAY (LMT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
Last Name:LEE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17807 KERRYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2796
Mailing Address - Country:US
Mailing Address - Phone:832-243-8853
Mailing Address - Fax:
Practice Address - Street 1:17807 KERRYBROOK LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2796
Practice Address - Country:US
Practice Address - Phone:832-243-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT139830225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist