Individual provider · NPI-1
Mallissa Lee
Spec/Tech, Cardiovascular · Sugar Land, TX
NPI number1720510902
StatusActive
Last updated in NPPESMar 28, 2017
Details
- NPI
- 1720510902
- Entity type
- Individual (NPI-1)
- Name
- Mallissa Lee
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 28, 2017
- Last updated
- Mar 28, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246X00000X | Spec/Tech, Cardiovascular | – | – | Yes |
| 171W00000X | Contractor | – | – | |
| 246XC2903X | Spec/Tech, Cardiovascular, Vascular Specialist | – | – | |
| 246YC3302X | Spec/Tech, Health Info, Coding Specialist, Physician Office Based | – | – | |
| 2471S1302X | Radiologic Technologist, Sonography | – | – | |
| 2471V0105X | Radiologic Technologist, Vascular Sonography | – | – |
Practice location
18545 University Blvd526
Sugar Land, TX 77479-4599
Phone 469-475-1285
Mailing address
18545 University Blvd526
Sugar Land, TX 77479-4599
Phone 469-475-1285
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