Provider Demographics
NPI:1780965087
Name:LEE, PAUL CRISTOPHER
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CRISTOPHER
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 FOXFIRE RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-6202
Mailing Address - Country:US
Mailing Address - Phone:405-657-7371
Mailing Address - Fax:
Practice Address - Street 1:1808 FOXFIRE RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-6202
Practice Address - Country:US
Practice Address - Phone:405-657-7371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator