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General NPI Number Information
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NPI Number | 1235650664
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Entity Type | Individual
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Provider Name | KEN MICHAEL LIM DMD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 201 E WILCO HWY STE 203
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City | HUTTO
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State | TX
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Zip | 78634-2739
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Country | US
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Telephone | 512-599-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 E 6TH ST APT 1538
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City | AUSTIN
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State | TX
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Zip | 78702-3342
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Country | US
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Telephone | 806-438-9080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33517
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License Number State | TX
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