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Organization
LEE R COLOSIMO MD PA
Active
Organization
LEE R COLOSIMO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE RALPH COLOSIMO M.D. (PHYSICIAN OWNER)
(281) 540-3838
Entity
Organization
Contact information
Practice address
19411 MCKAY BLVD, SUITE 250, HUMBLE, TX 77338-5713
(281) 540-3838
(281) 540-6773
Mailing address
19411 MCKAY BLVD, SUITE 250, HUMBLE, TX 77338-5713
(281) 540-3838
(281) 540-6773
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G1636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8511K0
BLUE CROSS OF TEXAS
TX
Enumeration date
12/20/2007
Last updated
12/20/2007
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