Provider Demographics
NPI:1518048297
Name:LIM, ELLEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:E
Last Name:LIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3700 BUFFALO SPEEDWAY
Mailing Address - Street 2:310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098
Mailing Address - Country:US
Mailing Address - Phone:713-850-9699
Mailing Address - Fax:713-850-1676
Practice Address - Street 1:3700 BUFFALO SPEEDWAY
Practice Address - Street 2:310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098
Practice Address - Country:US
Practice Address - Phone:713-850-9699
Practice Address - Fax:713-850-1676
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXTX18361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist