Provider Demographics
NPI:1639898992
Name:DE CARVALHO SAMPAIO LIMA, PATRICIA PAULA (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICIA PAULA
Middle Name:
Last Name:DE CARVALHO SAMPAIO LIMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:PATRICIA PAULA
Other - Middle Name:
Other - Last Name:ALVES DE CARVALHO SAMPAIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13303 CONCORDIA OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4862
Mailing Address - Country:US
Mailing Address - Phone:210-744-0644
Mailing Address - Fax:
Practice Address - Street 1:25235 W INTERSTATE 10
Practice Address - Street 2:STE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257
Practice Address - Country:US
Practice Address - Phone:210-698-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38937122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty