Basic Information
Provider Information
NPI: 1407382971
EntityType: 2
ReplacementNPI:  
OrganizationName: LEE & LEE-LAWNDALE,PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CROWN DENTAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10260 WESTHEIMER RD STE 390
Address2:  
City: HOUSTON
State: TX
PostalCode: 770423129
CountryCode: US
TelephoneNumber: 7139775300
FaxNumber: 7139775348
Practice Location
Address1: 7071 LAWNDALE ST STE D
Address2:  
City: HOUSTON
State: TX
PostalCode: 770234244
CountryCode: US
TelephoneNumber: 7139775300
FaxNumber: 7139775348
Other Information
ProviderEnumerationDate: 05/03/2017
LastUpdateDate: 05/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LEE
AuthorizedOfficialFirstName: KAY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DDS / OWNER
AuthorizedOfficialTelephone: 7139775300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DDS
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X TXY193400000X MULTIPLE SINGLE SPECIALTY GROUPDental ProvidersDentistGeneral Practice

No ID Information.


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