Provider Demographics
NPI:1669786687
Name:LEE, LYNDA
Entity type:Individual
Prefix:
First Name:LYNDA
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 1:4600 SCYENE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75210-2219
Mailing Address - Country:US
Mailing Address - Phone:214-266-1077
Mailing Address - Fax:214-266-1076
Practice Address - Street 1:11920 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2711
Practice Address - Country:US
Practice Address - Phone:972-980-4915
Practice Address - Fax:972-392-1506
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352261835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care