Provider Demographics
NPI:1164690137
Name:LIM, KARLY (RPH)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7979 WURZBACH RD # G354
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4427
Mailing Address - Country:US
Mailing Address - Phone:210-450-5885
Mailing Address - Fax:210-616-5589
Practice Address - Street 1:7979 WURZBACH RD # G354
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4427
Practice Address - Country:US
Practice Address - Phone:210-450-5885
Practice Address - Fax:210-616-5589
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist