Healthcare Provider Details

I. General information

NPI: 1083424022
Provider Name (Legal Business Name): ISSAC DONHYUN LIM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ISSAC DONHYUN LIM DO

II. Dates (important events)

Enumeration Date: 01/11/2025
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER ROAD
FT HOOD TX
76548
US

IV. Provider business mailing address

590 MEDICAL CENTER ROAD
FT HOOD TX
76548
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8888
  • Fax:
Mailing address:
  • Phone: 254-288-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: