Individual provider Active NPI

Michael Robert Lee, MD

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
National Provider Identifier
1265635866
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD.205962 Issued in LA
Practice address
4311 Oak Lawn Ave
Dallas, TX 75219-2315
Phone
(469) 730-2831
Fax
(469) 730-2695
NPI assigned
Jun 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD.205962 LA Primary
Facial Plastic Surgery Physician 207YS0123X MD.205962 LA
Plastic and Reconstructive Surgery Physician 2086S0122X M7367 TX

Addresses

Primary practice location

4311 Oak Lawn Ave
Dallas, TX 75219-2315

Mailing address

4311 Oak Lawn Ave
Dallas, TX 75219-2315
Phone (469) 730-2831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000471 TX Practitioner - Plastic and Reconstructive Surgery 2264514090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.205962LAMDFacial Plastic Surgery Physician
M7367TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 11, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 11, 2016 Accepting new patients
Bachman Lake Emergency Physicians PLLC Past Accepting new patients

Locations

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1265635866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 OAK LAWN AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192315",
            "telephone_number": "469-730-2831",
            "fax_number": "469-730-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 OAK LAWN AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192315",
            "telephone_number": "469-730-2831",
            "fax_number": "469-730-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "MD.205962",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "LA",
            "license": "MD.205962",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "M7367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.