Provider Demographics
NPI:1154029718
Name:LEE, PUI CHUN (RD)
Entity type:Individual
Prefix:MISS
First Name:PUI CHUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:4401 S COULTER ST APT 321
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5061
Mailing Address - Country:US
Mailing Address - Phone:210-204-3101
Mailing Address - Fax:
Practice Address - Street 1:1411 DENVER AVE
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-4809
Practice Address - Country:US
Practice Address - Phone:806-244-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86587133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered