Provider Demographics
NPI:1770961633
Name:PRICE, JUSTIN LEE (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:LEE
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:302 MEDICAL PARK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3129
Mailing Address - Country:US
Mailing Address - Phone:936-633-1230
Mailing Address - Fax:936-630-2078
Practice Address - Street 1:302 MEDICAL PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3129
Practice Address - Country:US
Practice Address - Phone:936-633-1230
Practice Address - Fax:936-630-2078
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR1849207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine