Provider Demographics
NPI:1487787461
Name:LEE, REGINA K (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:K
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10010 WESTOVER HILLS BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1968
Mailing Address - Country:US
Mailing Address - Phone:210-682-9434
Mailing Address - Fax:210-572-5748
Practice Address - Street 1:10010 WESTOVER HILLS BLVD STE 125
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1968
Practice Address - Country:US
Practice Address - Phone:210-682-9434
Practice Address - Fax:210-572-5748
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM8786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200444201Medicaid