Provider / Organization | NPI | Date Certified |
---|---|---|
CHUSILA SANTHONG LEE | 1275233033 | 2023-08-13 |
Chusila Santhong Lee is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1275233033. Registration indicates Chusila Santhong Lee is a provider of services with a specialization in Other Service Providers, Military Health Care Provider (Military Health Care Provider, ) (Military Health Care Provider, Other Service Providers)
Entity Type | Individual |
Provider Name | Dr. Chusila Santhong Lee DO |
Practice Office Address | 3551 ROGER BROOKE DR JBSA FT SAM HOU, TX US |
Practice Office Telephone | 2102927805 |
Practice Office Fax | 2102927868 |
Mailing Address | 3551 ROGER BROOKE DR JBSA FT SAM HOUSTON, TX 782344504 US |
Business Telephone | 2102927805 |
Business Fax | 2102927868 |
Address | City / State | Phone / Fax |
---|---|---|
3100 Schofield Rd | Jbsa Ft Sam Houston, TX 782347577 | 2109163000 |
1100 Wilford Hall Loop | Jbsa Lackland, TX 782365638 | 2102924277 |
Code | Practice | License No State |
---|---|---|
171000000X PRIMARY | Other Service Providers Military Health Care Provider Military Health Care Provider Military Health Care Provider Other Service Providers |