Provider Demographics
NPI:1932580743
Name:LEE, GRACE (DO)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 LOUETTA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1574
Mailing Address - Country:US
Mailing Address - Phone:832-241-8004
Mailing Address - Fax:833-973-5653
Practice Address - Street 1:10107 LOUETTA RD STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1574
Practice Address - Country:US
Practice Address - Phone:832-241-8004
Practice Address - Fax:833-973-5653
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6601207Q00000X
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program