Provider Demographics
NPI:1790887222
Name:LEE, DOOHI (MD)
Entity Type:Individual
Prefix:DR
First Name:DOOHI
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 W PLANO PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4858
Mailing Address - Country:US
Mailing Address - Phone:972-612-1900
Mailing Address - Fax:972-612-0900
Practice Address - Street 1:4100 W 15TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5803
Practice Address - Country:US
Practice Address - Phone:972-612-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL19202084P0301X, 2085R0202X, 2085R0204X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury Medicine
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C6386Medicare PIN