Active NPI
Kim L Lim, O.D.
- Optometrist
- San Benito, TX
National Provider Identifier
1790861797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3660
- Practice address
- 1126 W Hwy 77
San Benito, TX 78586-4337 - Phone
- (956) 399-1500
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3660 | TX | Primary |
Addresses
Primary practice location
1126 W Hwy 77
San Benito, TX 78586-4337
Mailing address
1126 W US Highway 77
San Benito, TX 78586-4337
Phone (956) 399-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0933558802 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160910000089 | TX | Order and Referring Only - Optometry | 8426344870 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3660 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1790861797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 W US HIGHWAY 77",
"city": "SAN BENITO",
"state": "TX",
"postal_code": "785864337",
"telephone_number": "956-399-1500",
"fax_number": "956-399-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 W HWY 77",
"city": "SAN BENITO",
"state": "TX",
"postal_code": "785864337",
"telephone_number": "956-399-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "KIM",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "3660",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0933558802",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Benito, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.