Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 125-051076 | IL |
NPI | 1013163146 |
---|---|
Provider Name | Dr. Robert Lee |
First Address | Austin, TX 78705-1851 |
Second Address | Austin, TX 78705-2703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 04/01/2022 |