Individual ProviderTaek Yeon LeeThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansPractice Address6410 Fannin St, 450, Houston, TX 77030-3000(713) 500-5304(713) 500-3500PECOS EnrollmentBased on the most recent information from CMS, provider Taek Yeon Lee does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1326213661Provider TypeIndividualFull NameLee, Taek YeonCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/28/2008Last Updated10/6/2008Contact InformationPractice LocationPractice Address6410 Fannin St, 450, Houston, TX 77030-3000Phone(713) 500-5304FaxUnlisted FaxMailing LocationMailing AddressPO Box 201088, Houston, TX 77216-1088Phone(713) 500-3500FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208G00000XPrimaryDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicenseFTL 42177TexasProvider IdentifiersIDDescriptionIssuerID8A4328DescriptionOtherIssuerBCBSTexasID193384801DescriptionMedicaidIssuerUnlistedTexas