Provider Demographics
NPI:1689211500
Name:LIM, GEORGINNE MABASA (APRN NP-C PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:GEORGINNE
Middle Name:MABASA
Last Name:LIM
Suffix:
Gender:F
Credentials:APRN NP-C PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S RANGERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-7638
Mailing Address - Country:US
Mailing Address - Phone:956-364-8000
Mailing Address - Fax:
Practice Address - Street 1:1401 S RANGERVILLE RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-7638
Practice Address - Country:US
Practice Address - Phone:956-364-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144295207Q00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP144295OtherAPRN