Provider Demographics
NPI:1265767768
Name:LIM, JOHN BRIAN CHAN II (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN BRIAN
Middle Name:CHAN
Last Name:LIM
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:8906 PERRIN BEITEL RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4851
Practice Address - Country:US
Practice Address - Phone:210-572-3306
Practice Address - Fax:210-249-0125
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2021-01-29
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Provider Licenses
StateLicense IDTaxonomies
TXQ4451207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3531857-01OtherWELLMED MEDICAID
TX447165YLPSOtherWELLMED MEDICARE