Provider Demographics
NPI:1447520671
Name:LEE, DONNY
Entity type:Individual
Prefix:
First Name:DONNY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 E HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7101
Mailing Address - Country:US
Mailing Address - Phone:956-412-8362
Mailing Address - Fax:956-412-8451
Practice Address - Street 1:1406 E HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7101
Practice Address - Country:US
Practice Address - Phone:956-412-8362
Practice Address - Fax:956-412-8451
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist