Provider Demographics
NPI:1437333531
Name:SUNG E. LIM MD PA
Entity Type:Organization
Organization Name:SUNG E. LIM MD PA
Other - Org Name:MERCEDES MEDICAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:956-565-1561
Mailing Address - Street 1:330 N OHIO ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-2728
Mailing Address - Country:US
Mailing Address - Phone:956-565-1561
Mailing Address - Fax:956-565-5373
Practice Address - Street 1:330 N OHIO AVE
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2728
Practice Address - Country:US
Practice Address - Phone:956-565-1561
Practice Address - Fax:956-565-5373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z296Medicare PIN