Individual
STACY L LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MIRON DR, SOUTHLAKE, TX 76092-7862
(817) 749-2000
(817) 749-2020
Mailing address
PO BOX 92038, SOUTHLAKE, TX 76092-0101
(817) 749-2001
(940) 483-1568
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD.206367
LA
2085R0202X
Diagnostic Radiology Physician
Primary
N2623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026377
INSTITUTIONAL PERMIT
—
Enumeration date
06/13/2007
Last updated
04/27/2026
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