Provider Demographics
NPI:1114118445
Name:LIM, CAROL MAY (RD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:MAY
Last Name:LIM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 ALMEDA RD
Mailing Address - Street 2:DAVITA REGION 4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7515
Mailing Address - Country:US
Mailing Address - Phone:713-520-6878
Mailing Address - Fax:
Practice Address - Street 1:5610 ALMEDA RD
Practice Address - Street 2:DAVITA REGION 4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7515
Practice Address - Country:US
Practice Address - Phone:832-816-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
922513133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
922513OtherCOMMISION OF DIETETIC REG