Provider Demographics
NPI:1619964152
Name:LEE, CHENG H (DC)
Entity Type:Individual
Prefix:DR
First Name:CHENG
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3602
Mailing Address - Country:US
Mailing Address - Phone:713-771-2225
Mailing Address - Fax:713-771-1876
Practice Address - Street 1:11100 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3602
Practice Address - Country:US
Practice Address - Phone:713-771-2225
Practice Address - Fax:713-771-1876
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
8M6610OtherBLUECROSS BLUESHIELD
U96294Medicare UPIN
609855Medicare ID - Type UnspecifiedMEDICARE