Basic Information
| Provider Information | |||||||||
| NPI: | 1538346267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIM | ||||||||
| FirstName: | TOBIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 13442 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787113442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122124865 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5656 BEE CAVES RD. BLDG C STE. 102 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123235465 | ||||||||
| FaxNumber: | 5123271390 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2008 | ||||||||
| LastUpdateDate: | 02/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 6851306-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | N3836 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | N3836 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 213710104 | 05 | TX | MEDICAID | 213710103 | 05 | TX | MEDICAID | 213710102 | 05 | TX | MEDICAID |