Provider Demographics
NPI:1295899367
Name:LEE, JANE (OD)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1201 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7100
Mailing Address - Country:US
Mailing Address - Phone:972-424-5811
Mailing Address - Fax:972-316-0308
Practice Address - Street 1:1201 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7100
Practice Address - Country:US
Practice Address - Phone:972-424-5811
Practice Address - Fax:972-316-0308
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5577TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist