Individual
JENNIFER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA07025
TX
363AS0400X
Surgical Physician Assistant
Primary
PA07025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282735402 (MDACC)
—
TX
01
—
849N73
BCBSTX
TX
01
—
8EQ700
BCBS (MDACC)
TX
Enumeration date
03/02/2011
Last updated
02/11/2015
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