NPIMap

Individual provider Active NPI

Il Woo Lee, L.AC

  • Acupuncturist
  • Dallas, TX
National Provider Identifier
1376797753
Registry record updated Mar 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01318 Issued in TX
Practice address
2257 Royal LN
Suite 100
Dallas, TX 75229-7819
Phone
(972) 241-0193
Fax
(972) 241-0193
NPI assigned
Nov 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC12589 CA
Acupuncturist 171100000X AC01318 TX Primary

Addresses

Primary practice location

2257 Royal LN
Suite 100
Dallas, TX 75229-7819

Mailing address

2257 Royal LN
Suite 100
Dallas, TX 75229-7819
Phone (972) 241-0193

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

State licenses

LicenseStateTypeSpecialty
AC12589CAMDAcupuncturist
AC01318TXMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Acupuncture Clinic Inc Acupuncturist Past Accepting new patients

Organizations & group practices 1

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": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331337600000",
    "number": "1376797753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 ROYAL LN",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752297819",
            "telephone_number": "972-241-0193",
            "fax_number": "972-241-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 ROYAL LN",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752297819",
            "telephone_number": "972-241-0193",
            "fax_number": "972-241-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "IL WOO",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2012-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12589",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.