Provider Demographics
NPI:1912223587
Name:LIM, JANET M (MD, MBA)
Entity Type:Individual
Prefix:MISS
First Name:JANET
Middle Name:M
Last Name:LIM
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 GREENBRIAR ST
Mailing Address - Street 2:APT. 4201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1454
Mailing Address - Country:US
Mailing Address - Phone:951-660-0587
Mailing Address - Fax:
Practice Address - Street 1:1550 OAK ST STE 5
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-687-2110
Practice Address - Fax:541-484-3883
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD181869207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500730920Medicaid
TX380215YQQ8Medicare PIN