Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | H3693 | TX |
NPI | 1174575831 |
---|---|
Provider Name | Dr. Moonhee Lee |
First Address | Arlington, TX 76016-2784 |
Second Address | Arlington, TX 76016-2784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 03/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
127681801 | (05) | TX |
C18245 | (02) | TX |