Provider Demographics
NPI:1902810112
Name:LEE, RICHARD W (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13330 HARGRAVE ROAD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-737-2918
Mailing Address - Fax:281-737-2919
Practice Address - Street 1:13330 HARGRAVE ROAD
Practice Address - Street 2:SUITE 390
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-737-2918
Practice Address - Fax:281-737-2919
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6465208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217496302Medicaid
TX8CK712OtherBCBS
TX217496303Medicaid
TX217496301Medicaid
TXP01070308OtherRR MEDICARE
TX1902810112OtherBLUE CROSS BLUE SHIELD
TXP00950623OtherMEDICARE RR
TXTXB145699Medicare PIN
TXP01070308OtherRR MEDICARE
TX8CK712OtherBCBS
TX217496301Medicaid
SDP00427807Medicare PIN
SDS101637Medicare PIN