Provider Demographics
NPI:1154727238
Name:LEE, JIN KYUNG (RPH)
Entity type:Individual
Prefix:MISS
First Name:JIN KYUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7080 VIRGINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5720
Mailing Address - Country:US
Mailing Address - Phone:972-540-2332
Mailing Address - Fax:972-540-6441
Practice Address - Street 1:7080 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75010-3842
Practice Address - Country:US
Practice Address - Phone:972-540-2332
Practice Address - Fax:972-540-6441
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist