Provider Demographics
NPI:1104905991
Name:LEE J FRIEND MD PA
Entity type:Organization
Organization Name:LEE J FRIEND MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-683-7140
Mailing Address - Street 1:3512 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4036
Mailing Address - Country:US
Mailing Address - Phone:806-683-7140
Mailing Address - Fax:
Practice Address - Street 1:3512 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4036
Practice Address - Country:US
Practice Address - Phone:806-683-7140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty