MEDICARE: DONG H KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	217109	MA
2	207T00000X	Neurological Surgery Physician	FTL 42013	TX
3	207T00000X	Neurological Surgery Physician	K6051	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043292550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONG H KIM MD

Provider Business Mailing Address
First Line	:	6400 FANNIN ST STE 2070
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1541
Country	:	US
Telephone Number	:	713-486-7747
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST
Second Line	:	STE 2800
City	:	HOUSTON
State	:	TX
Zip	:	77030-1521
Country	:	US
Telephone Number	:	713-486-8000
Fax Number	:	713-486-8088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	02/03/2020

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Directions to “ DONG H KIM MD” Practice Location

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