Individual
DR. LEE E ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F3023
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125761004
—
TX
01
—
390001614
RR MEDICARE
TX
01
—
87C962
BLUE CROSS
TX
Enumeration date
08/16/2005
Last updated
08/04/2014
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