OrganizationDr. Samuel C. Lee, PaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address800 8th Ave Ste 528, Fort Worth, TX 76104-2604(817) 625-8818PECOS EnrollmentBased on the most recent information from CMS, provider Dr. Samuel C. Lee, Pa 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 3 days ago.Profile DetailsProvider ID1861677700Provider TypeOrganizationFull NameDr. Samuel C. Lee, PaSubpartNoEnumeration Date1/9/2008Last Updated11/6/2020Contact InformationPractice LocationPractice Address800 8th Ave Ste 528, Fort Worth, TX 76104-2604Phone(817) 625-8818Fax(817) 625-7850Mailing LocationMailing Address800 8th Ave Ste 528, Fort Worth, TX 76104-2604Phone(817) 625-8818Fax(817) 625-7850Authorized OfficialNameShea, Shelly (Enrollment Specialist)Phone(817) 484-6274Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseK0107Texas