Jeffrey Joon Taek Lee, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

U0795 Issued in TX

Practice address

4401 Highway 6 S
College Station, TX 77845-4428

Phone

(979) 690-4480

Fax

(979) 690-4481

NPI assigned

May 28, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• TCH Pediatric Associates, Inc

  • Pediatrics Physician
  • Sugar Land, TX
  • NPI 1861492654
  NPD (past)

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1811510563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 HIGHWAY 6 S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454428",
            "telephone_number": "979-690-4480",
            "fax_number": "979-690-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HIGHWAY 6 S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454428",
            "telephone_number": "979-690-4480",
            "fax_number": "979-690-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEFFREY",
        "middle_name": "JOON TAEK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U0795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lechler, PHARM.D.
• Shane Lechler
• Kirk L. Leclear, O.D.
• Ruth Eunice Ledezma, CPHT
• Irene Lee, PHARM.D
• Winita J Lee, CRNA
• Avery Leidy
• Margaret Elizabeth Lejeune
• Linda Eloise Lekawski, D.O.
• Cameron Nicole Lemaster, PA-C

• Pediatrics Physician in College Station, TX
• Providers in College Station, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.