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General NPI Number Information
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NPI Number | 1275833907
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Entity Type | Organization
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Legal Business Name | NGAN, INC
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 6737 STELLA LINK RD
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City | HOUSTON
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State | TX
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Zip | 77005-4342
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Country | US
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Telephone | 713-432-1137
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Fax | 713-660-9909
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Provider Business Mailing Address
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Address Line | 6737 STELLA LINK RD
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City | HOUSTON
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State | TX
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Zip | 77005-4342
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Country | US
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Telephone | 713-432-1137
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Fax | 713-660-9909
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Authorized Official
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Title or Position | MD
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Name | JOHN M LIM
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Credential | MD
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Telephone | 713-432-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6433TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G3557
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License Number State | TX
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