Provider Demographics
NPI:1639315302
Name:STEWART-LEE, AUREYELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:AUREYELLE
Middle Name:
Last Name:STEWART-LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3468
Mailing Address - Country:US
Mailing Address - Phone:972-780-7199
Mailing Address - Fax:
Practice Address - Street 1:3900 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3468
Practice Address - Country:US
Practice Address - Phone:972-780-7199
Practice Address - Fax:972-780-9157
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7264T152W00000X
TX7264TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist