Provider Demographics
NPI:1235215351
Name:KULAS, LEE ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANN
Last Name:KULAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 E SCORPIO PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3652
Mailing Address - Country:US
Mailing Address - Phone:480-883-7484
Mailing Address - Fax:
Practice Address - Street 1:2750 E GERMANN RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-1403
Practice Address - Country:US
Practice Address - Phone:480-812-2948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01190152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU77454Medicare UPIN