Provider Demographics
NPI:1548329345
Name:LEE, TOMMIE (OD)
Entity type:Individual
Prefix:DR
First Name:TOMMIE
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 BRITE DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6307
Mailing Address - Country:US
Mailing Address - Phone:202-463-6241
Mailing Address - Fax:202-628-1842
Practice Address - Street 1:1304 G ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3004
Practice Address - Country:US
Practice Address - Phone:202-463-6241
Practice Address - Fax:202-628-1842
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP533152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist