Provider Demographics
NPI:1598324147
Name:LEE, JI HYAE (MD)
Entity type:Individual
Prefix:DR
First Name:JI HYAE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9725 DATAPOINT DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2385
Mailing Address - Country:US
Mailing Address - Phone:210-585-2020
Mailing Address - Fax:210-249-0209
Practice Address - Street 1:9725 DATAPOINT DR STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2385
Practice Address - Country:US
Practice Address - Phone:210-585-2020
Practice Address - Fax:210-249-0209
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDLT21951207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology