Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | N6465 | TX |
NPI | 1003027269 |
---|---|
Provider Name | Lee M. Lunsford |
First Address | Fort Worth, TX 76109 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2007 |
Last Update Date | 15/11/2012 |