Individual
ALBERT C LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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