Individual
JASON Z LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
E4176
AR
207RN0300X
Nephrology Physician
Primary
M1876
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154475001
—
AR
01
—
466853ZSR
MEDICARE - OK
OK
01
—
5M963B878
MEDICARE - ARK
AR
Enumeration date
07/28/2005
Last updated
07/29/2020
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