Provider Demographics
NPI:1104803923
Name:HAAK, LEE W (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:W
Last Name:HAAK
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE
Mailing Address - Street 2:BLDG B SUITE 203
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-9494
Mailing Address - Country:US
Mailing Address - Phone:956-686-7611
Mailing Address - Fax:956-618-3164
Practice Address - Street 1:5301 WILLIAM D TATE AVE
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7357
Practice Address - Country:US
Practice Address - Phone:817-251-2101
Practice Address - Fax:817-421-5041
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2296208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX740054OtherMEDICARE
TX146776321Medicaid
TX146776307Medicaid
TX8F1119Medicare PIN