Provider Demographics
NPI:1598969362
Name:LEE, MICHAEL JOO HYUN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOO HYUN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 SCRIPTURE ST STE 303
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2314
Mailing Address - Country:US
Mailing Address - Phone:940-323-3450
Mailing Address - Fax:940-323-3451
Practice Address - Street 1:2501 SCRIPTURE ST STE 303
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2314
Practice Address - Country:US
Practice Address - Phone:940-323-3450
Practice Address - Fax:940-323-3451
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0080208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX392616YKP5Medicare PIN