Provider Demographics
NPI:1902909377
Name:LEE, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1809 GOLDEN TRAIL COURT
Mailing Address - Street 2:#220
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010
Mailing Address - Country:US
Mailing Address - Phone:214-731-1166
Mailing Address - Fax:214-731-1628
Practice Address - Street 1:1809 GOLDEN TRAIL COURT
Practice Address - Street 2:#220
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010
Practice Address - Country:US
Practice Address - Phone:214-731-1166
Practice Address - Fax:214-731-1628
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK6087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31413001Medicaid
TX31413001Medicaid
G41419Medicare UPIN