Provider Demographics
NPI:1902849102
Name:WENG, LEE TUNGJEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:TUNGJEN
Last Name:WENG
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 1:11661 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-4107
Mailing Address - Country:US
Mailing Address - Phone:913-954-8500
Mailing Address - Fax:
Practice Address - Street 1:11661 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4107
Practice Address - Country:US
Practice Address - Phone:913-954-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS206452084P0800X
NC2020-031332084P0800X
MOR7G242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO15303016OtherBLUE CROSS BLUE SHIELD
MO202597118Medicaid
MOA980186Medicare ID - Type Unspecified
MO15303016OtherBLUE CROSS BLUE SHIELD
A980000Medicare PIN