Provider Demographics
NPI:1982705240
Name:LEE, BYOUNG CHAN (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:BYOUNG
Middle Name:CHAN
Last Name:LEE
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13740 N HIGHWAY 183 STE G3
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1821
Mailing Address - Country:US
Mailing Address - Phone:512-339-1888
Mailing Address - Fax:512-339-1889
Practice Address - Street 1:13740 N HIGHWAY 183 STE G3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1821
Practice Address - Country:US
Practice Address - Phone:512-339-1888
Practice Address - Fax:512-339-1889
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01614171100000X
TX10937111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L20939Medicare PIN