Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | R8229 | TX |
NPI | 1194024562 |
---|---|
Provider Name | Dr. Jessica Lee |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 19/09/2018 |