Individual
JENNIFER IRENE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
7110 HUNNINGTON DR, SANGER, TX 76266-7954
(469) 360-4775
Mailing address
309 DEER RUN DR, SANGER, TX 76266-6606
(469) 360-4775
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
134113
TX
246ZS0410X
Surgical Technologist
96705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96705
96705
TX
Enumeration date
01/24/2012
Last updated
10/29/2024
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