Provider Demographics
NPI:1144217035
Name:LEE, YVONNE DENISE (OD)
Entity type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:DENISE
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:YVONNE
Other - Middle Name:DENISE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2445 E WILCOX DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2842
Mailing Address - Country:US
Mailing Address - Phone:520-458-8131
Mailing Address - Fax:520-458-0422
Practice Address - Street 1:4116 AVENIDA COCHISE STE A
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-5824
Practice Address - Country:US
Practice Address - Phone:520-452-1125
Practice Address - Fax:520-458-0422
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8631T152W00000X
AZ1179152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU86607Medicare UPIN
AZ84988Medicare ID - Type UnspecifiedMEDICARE/MEDICAID
AZ84990Medicare ID - Type UnspecifiedMEDICARE/MEDICAID