Individual
DR. AUGUSTINE CHANGDAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12740 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-8100
(480) 581-3600
(480) 581-3600
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(281) 724-3050
(281) 724-3100
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
274910
MA
208100000X
Physical Medicine & Rehabilitation Physician
282952
MA
208100000X
Physical Medicine & Rehabilitation Physician
63159
TN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
68595
AZ
208100000X
Physical Medicine & Rehabilitation Physician
93296
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208019
—
AZ
Enumeration date
05/03/2017
Last updated
11/04/2025
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