Provider Demographics
NPI:1598075707
Name:LEE, HONG TAI (DC)
Entity Type:Individual
Prefix:DR
First Name:HONG
Middle Name:TAI
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:5037 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:STE 2C
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5133
Mailing Address - Country:US
Mailing Address - Phone:682-518-9393
Mailing Address - Fax:682-518-9398
Practice Address - Street 1:121 W DEBBIE LN
Practice Address - Street 2:STE 115
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8941
Practice Address - Country:US
Practice Address - Phone:682-518-9393
Practice Address - Fax:682-518-9398
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2019-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL038.011655111N00000X
LA1872111N00000X
TX11938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty