Dr. Jaebum Lee
Periodontist
2035 Fort Worth Hwy Ste 500
Weatherford
, Texas 76086-4785
Dr. Jaebum Lee
Periodontist
2035 Fort Worth Hwy Ste 500
Weatherford
, Texas 76086-4785
(682) 433-3144
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Jaebum Lee
- 2573 Hall Johnson Rd Apt 1111
- Grapevine, TX
- Zip : 76051-8702
- Phone : (682) 433-3144
Second Address
- Dr. Jaebum Lee
- 2035 Fort Worth Hwy Ste 500
- Weatherford, TX
- Zip : 76086-4785
- Phone : (817) 598-1900
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 29604 | TX |
National Provider Identifier
| NPI | 1083921340 |
|---|---|
| Provider Name | Dr. Jaebum Lee |
| First Address | Grapevine, TX 76051-8702 |
| Second Address | Weatherford, TX 76086-4785 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/09/2010 |
| Last Update Date | 21/07/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.