Provider Demographics
NPI:1750992327
Name:LEE, YOUNGSUN (APRN)
Entity type:Individual
Prefix:
First Name:YOUNGSUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 MATLOCK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4805
Mailing Address - Country:US
Mailing Address - Phone:817-473-7197
Mailing Address - Fax:817-473-7198
Practice Address - Street 1:8200 MATLOCK RD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4805
Practice Address - Country:US
Practice Address - Phone:817-473-7197
Practice Address - Fax:817-473-7198
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003148363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care