Provider Demographics
NPI:1639560535
Name:LEE, TRISTAN (BVSC)
Entity Type:Individual
Prefix:DR
First Name:TRISTAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:BVSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 E HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-6857
Mailing Address - Country:US
Mailing Address - Phone:817-240-8375
Mailing Address - Fax:
Practice Address - Street 1:6800 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-6857
Practice Address - Country:US
Practice Address - Phone:817-240-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian