Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | BP10068342 | TX |
NPI | 1003377755 |
---|---|
Provider Name | Joshua Lee |
First Address | Temple, TX 76508 |
Second Address | Temple, TX 76508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2019 |
Last Update Date | 09/05/2019 |