Individual
MR. KWANHYEONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3600 WINDHAVEN PKWY APT 3107, LEWISVILLE, TX 75056-6666
(803) 446-0651
Mailing address
3600 WINDHAVEN PKWY APT 3107, LEWISVILLE, TX 75056-6666
(803) 446-0651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000032431
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000032431
—
TX
Enumeration date
11/02/2018
Last updated
11/02/2018
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