Provider Demographics
NPI:1003102286
Name:LEE, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E HOWARD LN
Mailing Address - Street 2:SUITE C-2E
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8288
Mailing Address - Country:US
Mailing Address - Phone:512-251-8893
Mailing Address - Fax:512-251-0893
Practice Address - Street 1:1900 E HOWARD LN
Practice Address - Street 2:SUITE C-2E
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8288
Practice Address - Country:US
Practice Address - Phone:512-251-8893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies