Individual
ALBERT C LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 E DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 593-1721
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G58417
CA
2085R0202X
Diagnostic Radiology Physician
Primary
N0916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196640001
—
TX
05
—
196640002
—
TX
05
—
196640003
—
TX
05
—
196640004
—
TX
01
—
8AP484
BCBS
TX
01
—
8BC077
BCBS OF TEXAS
TX
01
—
8CU212
BCBS JV LOCATION
TX
01
—
TIN PLUS 005
TRICARE JV LOCATION
TX
01
—
TIN PLUS 007
TRICARE
TX
01
—
TIN PLUS 013
TRICARE
TX
01
—
TIN PLUS 113
TRICARE
TX
Enumeration date
07/18/2006
Last updated
01/04/2016
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