Active NPI
Jerry Wade Lee, PHARMD
- Psychiatric Pharmacist
- Lubbock, TX
National Provider Identifier
1336341254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 36271
- Practice address
- 1950 Aspen
Lubbock, TX 79403 - Phone
- (806) 766-0268
- Fax
- (806) 767-1640
- NPI assigned
- Jun 4, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 36271 | TX | Primary |
Addresses
Primary practice location
1950 Aspen
Lubbock, TX 79403
Mailing address
1602 10TH St
Lubbock, TX 79401-2607
Phone (806) 766-0310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36271 | Other | TX | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36271 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336341254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1602 10TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794012607",
"telephone_number": "806-766-0310",
"fax_number": "806-744-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 ASPEN",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79403",
"telephone_number": "806-766-0268",
"fax_number": "806-767-1640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JERRY",
"middle_name": "WADE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "TX",
"license": "36271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "36271",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.