Individual
MR. LEE E PRADIA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
10651 E ST, NAVAL HOSPITAL, CORPUS CHRISTI, TX 78419-5130
(361) 961-6190
Mailing address
3310 CARTAGENA DR, CORPUS CHRISTI, TX 78418-3921
(361) 961-6190
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/03/2006
Last updated
08/24/2007
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