Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | K9593 | TX |
NPI | 1043295728 |
---|---|
Provider Name | Dr. Christine M. Lee |
First Address | Dallas, TX 75391-1230 |
Second Address | Shenandoah, TX 77380-3256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 27/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165799101 | (05) | TX |
165799103 | (05) | TX |
I08009 | (02) | TX |
P00760854 | RAILROAD MEDICARE (01) | TX |