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Organization

LEE R COLOSIMO MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEE RALPH COLOSIMO M.D. (PHYSICIAN OWNER)
(281) 540-3838
Entity
Organization

Contact information

Practice address
19411 MCKAY BLVD, SUITE 250, HUMBLE, TX 77338-5713
(281) 540-3838
(281) 540-6773
Mailing address
19411 MCKAY BLVD, SUITE 250, HUMBLE, TX 77338-5713
(281) 540-3838
(281) 540-6773

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G1636
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8511K0
BLUE CROSS OF TEXAS
TX
Enumeration date
12/20/2007
Last updated
12/20/2007
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