Individual
DR. JERRY WADE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1950 ASPEN, LUBBOCK, TX 79403
(806) 766-0268
(806) 767-1640
Mailing address
1602 10TH ST, LUBBOCK, TX 79401-2607
(806) 766-0310
(806) 744-9580
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
36271
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36271
LICENSE
TX
Enumeration date
06/04/2007
Last updated
07/08/2007
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