Provider Demographics
NPI:1588838528
Name:LEE V. ANSELL, M.D., P.A.
Entity Type:Organization
Organization Name:LEE V. ANSELL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:V
Authorized Official - Last Name:ANSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-314-4600
Mailing Address - Street 1:5420 WEST LOOP S
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2107
Mailing Address - Country:US
Mailing Address - Phone:713-314-4600
Mailing Address - Fax:713-314-2990
Practice Address - Street 1:5420 WEST LOOP S
Practice Address - Street 2:SUITE NO. 2400
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2107
Practice Address - Country:US
Practice Address - Phone:713-314-4600
Practice Address - Fax:713-314-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1342207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0074AXMedicare PIN
TXE18140Medicare UPIN