| Doctor Name: | DR. SONG YOUNG LEE |
| NPI Number: | 1194753319 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | K6877 |
| Business Practice Address: | 6220 Colleyville Blvd Suite B Colleyville, TX - 760346278 |
| Business Phone Number: | 8174160525 |
| Business Fax Number: | 8174165831 |
| Mailing Address: | 6220 Colleyville Blvd, Suite B COLLEYVILLE |
| State: | TX |
| Postal Code: | 760346278 |
| Phone Number: | 8174160525 |
| Fax Number: | 8174165831 |
| NPI Enumeration Date: | 06/28/2006 |
| NPI Last Update Date: | 02/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | K6877 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |