Provider Demographics
NPI:1366875213
Name:LEE, JANET (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PEI-CHI
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3575 PECOS MCLEOD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3803
Mailing Address - Country:US
Mailing Address - Phone:702-202-4776
Mailing Address - Fax:702-202-6110
Practice Address - Street 1:3575 PECOS MCLEOD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3803
Practice Address - Country:US
Practice Address - Phone:702-731-2088
Practice Address - Fax:702-734-7836
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133458207W00000X
NV17714207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1366875213Medicaid