| Southlake Endocrinology, Pllc | |
|
1202 S. Whilte Chapel Blvd Southlake TX 76092-3422 | |
| (707) 235-7166 | |
| Not Available |
| Full Name | Southlake Endocrinology, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1202 S. Whilte Chapel Blvd, Southlake, Texas |
| Authorized Official Name and Position | Do-eun Lee (OWNER) |
| Authorized Official Contact | 7072357166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southlake Endocrinology, Pllc 1501 Plantation Dr Southlake TX 76092-3422 Ph: (707) 235-7166 | Southlake Endocrinology, Pllc 1202 S. Whilte Chapel Blvd Southlake TX 76092-3422 Ph: (707) 235-7166 |
| NPI Number | 1558012997 |
|---|---|
| Provider Enumeration Date | 01/18/2022 |
| Last Update Date | 03/01/2022 |
| Medicare PECOS PAC ID | 5991191801 |
|---|---|
| Medicare Enrollment ID | O20220401000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558012997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Do-eun Lee |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346339652 PECOS PAC ID: 6901959162 Enrollment ID: I20220401000719 |
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