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Provider Information for 1265635866

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MICHAEL ROBERT LEE MD

Gender: MALE

Individual NPI: 1265635866

Calendar Last Updated: 2017-05-09

Details

Name Value
NPI 1265635866
Enumeration Date 2007-06-09
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4311 OAK LAWN AVE
DALLAS, TX 75219-2315
United States

Phone: 469-730-2831 | Fax: 469-730-2695
View Map External Link
Primary Practice Address 4311 OAK LAWN AVE
DALLAS, TX 75219-2315
United States

Phone: 469-730-2831 | Fax: 469-730-2695
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2086S0122X - Surgery Plastic and Reconstructive Surgery LA MD.205962
No 207YS0123X - Otolaryngology Facial Plastic Surgery LA MD.205962
No 2086S0122X - Surgery Plastic and Reconstructive Surgery TX M7367