Provider Demographics
NPI:1821047515
Name:WEBSTER, CHAN LEE (OD)
Entity type:Individual
Prefix:DR
First Name:CHAN
Middle Name:LEE
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2766 HARNEY PATH PMB 307
Mailing Address - Street 2:
Mailing Address - City:JBSA FSH
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-683-3001
Mailing Address - Fax:210-539-2086
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-9588
Practice Address - Fax:210-539-2086
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1741152W00000X
TN1741152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist