Provider Demographics
NPI:1568827236
Name:LEE, ROWAN ALEX ROCA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROWAN ALEX
Middle Name:ROCA
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 LACY STREET
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5800 BELLAIRE BLVD
Practice Address - Street 2:110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5537
Practice Address - Country:US
Practice Address - Phone:713-667-4077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist