Provider Demographics
NPI:1992044176
Name:LEE, STEVEN MYOUNG-SUK (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MYOUNG-SUK
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 N. CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-369-8161
Mailing Address - Fax:
Practice Address - Street 1:1609 N. CONWAY AVE
Practice Address - Street 2:W. DAVID EGGER DDS PA
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-519-9398
Practice Address - Fax:956-519-7166
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX286371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3112708-06Medicaid