Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | R5589 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | R5589 | TX |
NPI | 1093131302 |
---|---|
Provider Name | Luis Pablo Lee |
First Address | Harlingen, TX 78553-4358 |
Second Address | Harlingen, TX 78550-8307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2014 |
Last Update Date | 31/01/2018 |