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Individual

TAE YOUNG LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
560 W MAIN ST, SUITE 101, LEWISVILLE, TX 75057-3629
(972) 221-1741
Mailing address
4100 FAIRWAY DR, SUITE 200, CARROLLTON, TX 75010
(972) 221-1741
(972) 939-2822

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
M8787
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
M8787
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP2-0022474
INSTITUTIONAL PERMIT
Enumeration date
06/12/2007
Last updated
03/28/2019
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