Provider Demographics
NPI:1609197532
Name:LEE, FRANK FANG-CHUNG (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:FANG-CHUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1505 WIGWAM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8195
Mailing Address - Country:US
Mailing Address - Phone:702-485-5000
Mailing Address - Fax:702-485-5001
Practice Address - Street 1:9100 W POST RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2418
Practice Address - Country:US
Practice Address - Phone:702-896-6043
Practice Address - Fax:702-896-9591
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL0726207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1609197532Medicaid