Provider Demographics
NPI:1275080160
Name:LEE, ANDREW K (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:417 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5893
Mailing Address - Country:US
Mailing Address - Phone:909-217-4878
Mailing Address - Fax:
Practice Address - Street 1:5575 WARREN PKWY STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4093
Practice Address - Country:US
Practice Address - Phone:469-200-2832
Practice Address - Fax:469-269-1074
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA10693363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical