Provider Demographics
NPI:1487746129
Name:LEE, ANDREW K (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:1501 W ROYAL LANE
Practice Address - Street 2:TEXAS CENTER FOR PROTON THERAPY
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:469-513-5500
Practice Address - Fax:469-420-9600
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL33762085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146110501Medicaid
TX146110502Medicaid
TX146110503Medicaid
TX146110504Medicaid
TXP01667430OtherRAILROAD
TX146110502Medicaid
TX403300YM09Medicare PIN
G58312Medicare UPIN
TX146110503Medicaid