Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2018014586 | MO |
Y | 204F00000X | Transplant Surgeon | S9020 | TX |
N | 208200000X | Surgeon | 2018014586 | MO |
N | 208600000X | Surgeon | 2018014586 | MO |
NPI | 1851734784 |
---|---|
Provider Name | Dr. Seung Hee Suzie Lee |
First Address | Dallas, TX 75246-2064 |
Second Address | Dallas, TX 75246-2064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2013 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S9020 | TX MEDICAL LICENSE (01) | TX |