Provider Demographics
NPI:1316253776
Name:LEE&LEE HIRAM CLARK PLLC
Entity type:Organization
Organization Name:LEE&LEE HIRAM CLARK PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-977-5300
Mailing Address - Street 1:10260 WESTHEIMER RD
Mailing Address - Street 2:STE 390
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3110
Mailing Address - Country:US
Mailing Address - Phone:713-977-5300
Mailing Address - Fax:713-977-5348
Practice Address - Street 1:4407 W FUQUA ST # R
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-6256
Practice Address - Country:US
Practice Address - Phone:713-434-7333
Practice Address - Fax:713-434-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177045501Medicaid