Provider Demographics
NPI:1932470689
Name:LEE, STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4110 ALMEDA ROAD
Mailing Address - Street 2:PO BOX 8321
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:346-253-0023
Mailing Address - Fax:346-253-0024
Practice Address - Street 1:3129 KINGSLEY DR STE 640
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8508
Practice Address - Country:US
Practice Address - Phone:346-253-0023
Practice Address - Fax:346-253-0024
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR8405207RN0300X
CAA124564207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA113793OtherSID #113793