| Dr. Samuel C. Lee, PA | |
|
800 8th Ave Ste 528 Fort Worth TX 76104-2604 | |
| (817) 625-8818 | |
| (817) 625-7850 |
| Full Name | Dr. Samuel C. Lee, PA |
|---|---|
| Speciality | Family Medicine |
| Location | 800 8th Ave Ste 528, Fort Worth, Texas |
| Authorized Official Name and Position | Shelly Shea (ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 8174846274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Samuel C. Lee, PA 800 8th Ave Ste 528 Fort Worth TX 76104-2604 Ph: (817) 625-8818 | Dr. Samuel C. Lee, PA 800 8th Ave Ste 528 Fort Worth TX 76104-2604 Ph: (817) 625-8818 |
| NPI Number | 1861677700 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 11/06/2020 |
| Certification Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861677700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K0107 (Texas) | Primary |
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