Provider Demographics
NPI:1780679019
Name:LIM, ALEXANDER R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:R
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1521 S STAPLES ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3150
Mailing Address - Country:US
Mailing Address - Phone:361-883-1731
Mailing Address - Fax:361-883-1440
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:SUITE 402
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3150
Practice Address - Country:US
Practice Address - Phone:361-883-1731
Practice Address - Fax:361-883-1440
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131900034OtherRAILROAD MEDICARE
TX101759201Medicaid
TX812584OtherBCBS
TX101759201Medicaid
TXC18425Medicare UPIN