Provider Demographics
NPI:1275850844
Name:LEE, FRED S (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5214 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5039
Mailing Address - Country:US
Mailing Address - Phone:214-263-5350
Mailing Address - Fax:
Practice Address - Street 1:4001 W 15TH ST STE 425
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5848
Practice Address - Country:US
Practice Address - Phone:972-696-0030
Practice Address - Fax:972-696-0037
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-22
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2654208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery