Individual
MS. ELAINE MARCEL DUET-LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
1058048
TX
225100000X
Physical Therapist
Primary
1058048
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0370272-02
—
TX
01
—
1058048
PHYSICAL THERAPIST
TX
01
—
819T65
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/16/2007
Last updated
01/12/2016
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