Provider Demographics
NPI:1215272380
Name:LEE, CHUN-TEH (DDS,MD,DMSC)
Entity type:Individual
Prefix:
First Name:CHUN-TEH
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS,MD,DMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 6470
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2032
Mailing Address - Country:US
Mailing Address - Phone:713-486-4049
Mailing Address - Fax:713-486-4393
Practice Address - Street 1:7500 CAMBRIDGE ST
Practice Address - Street 2:SUITE 6470
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2032
Practice Address - Country:US
Practice Address - Phone:713-486-4049
Practice Address - Fax:713-486-4393
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL117691223P0300X
TX28664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics