Provider Demographics
NPI:1457308348
Name:JEFFREY Y LEE, MDPA
Entity Type:Organization
Organization Name:JEFFREY Y LEE, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-464-7212
Mailing Address - Street 1:8495 LONG POINT RD
Mailing Address - Street 2:212
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-2308
Mailing Address - Country:US
Mailing Address - Phone:713-464-7212
Mailing Address - Fax:713-464-7236
Practice Address - Street 1:8495 LONG POINT RD
Practice Address - Street 2:212
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2308
Practice Address - Country:US
Practice Address - Phone:713-464-7212
Practice Address - Fax:713-464-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX828013194OtherMEDICARE RAILROAD
TX080277901Medicaid
TX00276KOtherBLUE CROSS BLUE SHIELD
TX00276KOtherBLUE CROSS BLUE SHIELD