Provider Demographics
NPI:1548933781
Name:BOR, LILIAN JELIMO
Entity type:Individual
Prefix:MS
First Name:LILIAN
Middle Name:JELIMO
Last Name:BOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILIAN
Other - Middle Name:
Other - Last Name:JELIMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:1100 W. REYNOSA AVE.
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444
Mailing Address - Country:US
Mailing Address - Phone:254-893-5895
Mailing Address - Fax:888-895-1214
Practice Address - Street 1:2100 CROCKETT DR.
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5918
Practice Address - Country:US
Practice Address - Phone:325-646-0704
Practice Address - Fax:888-895-1214
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1047417363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health