Provider Demographics
NPI:1730400854
Name:LEE, JANE EVELYN (DO)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:EVELYN
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 NORTH IH 35
Mailing Address - Street 2:PROFESSIONAL PLAZA 1, SUITE 100
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:469-800-9500
Mailing Address - Fax:
Practice Address - Street 1:2460 NORTH IH 35
Practice Address - Street 2:PROFESSIONAL PLAZA 1, SUITE 100
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:469-800-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine