Individual ProviderLee CarlisleAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address4502 Medical Dr, San Antonio, TX 78229-4402(210) 257-1400(210) 358-4000PECOS EnrollmentBased on the most recent information from CMS, provider Lee Carlisle is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1194832170Provider TypeIndividualFull NameCarlisle, LeeCredentialMDGenderFemaleSole ProprietorNoEnumeration Date8/24/2006Last Updated5/6/2009Contact InformationPractice LocationPractice Address4502 Medical Dr, San Antonio, TX 78229-4402Phone(210) 257-1400FaxUnlisted FaxMailing LocationMailing AddressUthscsa, Uthscsa, Dept. Anesthesiology, 7703 Floyd Curl Drive, Rm 321.5e, San Antonio, TX 78229Phone(210) 358-4000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseL5268TexasProvider IdentifiersIDDescriptionIssuerID173043401DescriptionOtherIssuerCIDCTexasID173043401DescriptionMedicaidIssuerUnlistedTexasID173043402DescriptionMedicaidIssuerUnlistedTexas