Provider Demographics
NPI:1861156812
Name:LIMA, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:LIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2734
Mailing Address - Country:US
Mailing Address - Phone:469-831-5926
Mailing Address - Fax:
Practice Address - Street 1:7200 SNUG HARBOR CIR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-9201
Practice Address - Country:US
Practice Address - Phone:972-947-9453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist