Individual
LEE S ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 W MAGNOLIA AVE, SUITE 202, FORT WORTH, TX 76104-8517
(817) 334-0882
(817) 334-0885
Mailing address
PO BOX 650037, DALLAS, TX 75265-0037
(214) 696-2008
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E2439
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48797702
—
TX
05
—
48797703
—
TX
Enumeration date
11/02/2005
Last updated
04/11/2014
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