Provider Demographics
NPI:1821163122
Name:LEE, EMMANUEL JOHN (M D)
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:JOHN
Last Name:LEE
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:3001 BEE CAVES RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ROLLINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-434-0037
Mailing Address - Fax:512-434-0037
Practice Address - Street 1:3001 BEE CAVES RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ROLLINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-434-0037
Practice Address - Fax:512-434-0037
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2025-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM4274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM4274OtherLISCENSE NUMBER
TX40148257OtherDPS NUMBER