Provider Demographics
NPI:1982602587
Name:JANE J LEE MD PA
Entity Type:Organization
Organization Name:JANE J LEE MD PA
Other - Org Name:TEXAS ALLERGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-370-5700
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:STE 2400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-370-5700
Mailing Address - Fax:214-358-4324
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:STE 2400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-370-5700
Practice Address - Fax:214-358-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1367207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00714UMedicare PIN
H50421Medicare UPIN