Provider Demographics
NPI:1023281680
Name:LEE FAMILY PRACTICE ASSOCIATES PA
Entity type:Organization
Organization Name:LEE FAMILY PRACTICE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-865-2031
Mailing Address - Street 1:11 WINDCREEK ST
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5656
Mailing Address - Country:US
Mailing Address - Phone:281-865-2031
Mailing Address - Fax:281-332-4100
Practice Address - Street 1:1505 WINDING WAY DR STE 218
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5395
Practice Address - Country:US
Practice Address - Phone:281-482-5551
Practice Address - Fax:281-482-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9413207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115123502Medicaid
1174500144OtherNPI
I26646OtherUPIN
1174500144OtherNPI