Individual
DR. JIWON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 W MAIN ST, LEWISVILLE, TX 75057-3629
(972) 420-1881
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M4276
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181656301
—
TX
05
—
181656302
—
TX
01
—
8V2878
BCBS
TX
01
—
8W0340
BCBS
TX
01
—
P00364140
RAILROAD
TX
Enumeration date
07/10/2006
Last updated
12/04/2007
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