Provider Demographics
NPI:1548695455
Name:LEE, MARKITA ALLEN (NP-C)
Entity type:Individual
Prefix:
First Name:MARKITA
Middle Name:ALLEN
Last Name:LEE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9447 BLACK TOOTH WAY
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1798
Mailing Address - Country:US
Mailing Address - Phone:832-541-3929
Mailing Address - Fax:281-441-8558
Practice Address - Street 1:130 SAWDUST RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2272
Practice Address - Country:US
Practice Address - Phone:713-335-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily