Provider Demographics
NPI:1861460651
Name:LEE, CHEVY CHU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEVY
Middle Name:CHU
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1913 S 1ST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1281
Mailing Address - Country:US
Mailing Address - Phone:956-686-2464
Mailing Address - Fax:956-686-5101
Practice Address - Street 1:1913 S 1ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1281
Practice Address - Country:US
Practice Address - Phone:956-686-2464
Practice Address - Fax:956-686-5101
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE4477207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0895542-02Medicaid
TXTXB146373OtherMEDICARE PTAN
TXTXB146373OtherMEDICARE PTAN
TXC18282Medicare UPIN