Provider Demographics
NPI:1790012664
Name:LEE, THI (PHARM D)
Entity Type:Individual
Prefix:
First Name:THI
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32320 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:TX
Mailing Address - Zip Code:77362-3892
Mailing Address - Country:US
Mailing Address - Phone:832-934-0415
Mailing Address - Fax:
Practice Address - Street 1:32320 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:TX
Practice Address - Zip Code:77362-3892
Practice Address - Country:US
Practice Address - Phone:832-934-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist