Provider Demographics
NPI:1841457306
Name:LEE, TIMOTHY CHEN-AN (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CHEN-AN
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 1:6701 FANNIN ST
Mailing Address - Street 2:C.C. 650.00
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2316
Mailing Address - Country:US
Mailing Address - Phone:832-822-3135
Mailing Address - Fax:832-825-3141
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:C.C. 650.00
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-822-3135
Practice Address - Fax:832-825-3141
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL64922086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB108948Medicare PIN