Provider Demographics
NPI:1740267046
Name:LEE, STEVEN WEIBUN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WEIBUN
Last Name:LEE
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:PO BOX 650426
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0426
Mailing Address - Country:US
Mailing Address - Phone:972-715-5007
Mailing Address - Fax:972-715-5682
Practice Address - Street 1:13601 PRESTON RD STE 1000W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4911
Practice Address - Country:US
Practice Address - Phone:972-663-8523
Practice Address - Fax:972-663-8329
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3377207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150368204Medicaid
TX8F3576OtherBCBS
TX150368201Medicaid
TX8L27110Medicare PIN
TX150368204Medicaid
TX150368201Medicaid
TX8C5844Medicare PIN