Provider Demographics
NPI:1740591858
Name:LIMA, SHIRLEY DESOUSA (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:DESOUSA
Last Name:LIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4105
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566
Mailing Address - Country:US
Mailing Address - Phone:979-292-0502
Mailing Address - Fax:979-292-0531
Practice Address - Street 1:210 LAKE RD STE 300
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566
Practice Address - Country:US
Practice Address - Phone:979-292-0502
Practice Address - Fax:979-292-0531
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6060207V00000X
MI4301098618207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology