Provider Demographics
NPI:1477030567
Name:LEE, BRANDON RONALD (OD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:RONALD
Last Name:LEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-1398
Mailing Address - Country:US
Mailing Address - Phone:972-459-2587
Mailing Address - Fax:
Practice Address - Street 1:2403 S STEMMONS FWY STE 113
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-2314
Practice Address - Country:US
Practice Address - Phone:972-459-2587
Practice Address - Fax:469-455-2095
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9531152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist