Individual
DR. GONG WONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75391-1589
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J4300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113660802
—
TX
05
—
164583001
—
TX
05
—
164583005
—
TX
01
—
8EW782
BCBS TX
TX
Enumeration date
05/12/2006
Last updated
10/29/2015
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