Provider Demographics
NPI:1801880406
Name:LIM, HELEN ONG (OD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ONG
Last Name:LIM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 S PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6335
Mailing Address - Country:US
Mailing Address - Phone:901-345-8464
Mailing Address - Fax:901-332-2643
Practice Address - Street 1:4064 S PLAZA DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6335
Practice Address - Country:US
Practice Address - Phone:901-345-8464
Practice Address - Fax:901-332-2643
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1382152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3082871OtherBCBS
TN4482020001Medicare NSC
TN3082871OtherBCBS
U31412Medicare UPIN