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2801 Lemmon Ave Ste 400 Dallas TX 75204-2399 | |
| (214) 303-1033 | |
| (214) 303-1032 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2801 Lemmon Ave Ste 400, Dallas, Texas |
| Authorized Official Name and Position | David M Lee (MD) |
| Authorized Official Contact | 2143031033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2801 Lemmon Ave Ste 400 Dallas TX 75204-2399 Ph: (214) 303-1033 | 2801 Lemmon Ave Ste 400 Dallas TX 75204-2399 Ph: (214) 303-1033 |
| NPI Number | 1073576864 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 08/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073576864 | NPI | - | NPPES |
| 0006MQ | Other | TX | BC/BS |
| 173762901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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