Provider Demographics
NPI:1407963796
Name:LIMMER, BYRON LEE (MD)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:LEE
Last Name:LIMMER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4630 N LOOP 1604 W
Mailing Address - Street 2:STE 316
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1373
Mailing Address - Country:US
Mailing Address - Phone:210-496-9929
Mailing Address - Fax:210-496-6699
Practice Address - Street 1:14615 SAN PEDRO AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4374
Practice Address - Country:US
Practice Address - Phone:210-496-9929
Practice Address - Fax:210-496-6699
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2018-01-18
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Provider Licenses
StateLicense IDTaxonomies
TXH8212207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF28753Medicare UPIN
TX86130JMedicare PIN