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General NPI Number Information
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NPI Number | 1194947572
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Entity Type | Organization
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Legal Business Name | JOSE AUDIE E LIM, M.D.,P.A.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1518 10TH STREET
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City | WICHITA FALLS
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State | TX
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Zip | 76301
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Country | US
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Telephone | 940-767-5111
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Fax | 940-767-5011
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Provider Business Mailing Address
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Address Line | 1518 10TH STREET
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City | WICHITA FALLS
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State | TX
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Zip | 76301
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Country | US
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Telephone | 940-767-5111
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Fax | 940-767-5011
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JOSE AUDIE E. LIM
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Credential | M.D.
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Telephone | 940-767-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K4886
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License Number State | TX
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