Healthcare Provider Details

I. General information

NPI: 1770410300
Provider Name (Legal Business Name): DEBORAH JOO-HEE KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBBIE KIM MD

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RED RIVER ST FL 2
AUSTIN TX
78712-1845
US

IV. Provider business mailing address

1501 RED RIVER ST FL 2
AUSTIN TX
78712-1845
US

V. Phone/Fax

Practice location:
  • Phone: 512-495-5555
  • Fax:
Mailing address:
  • Phone: 512-495-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP10097950
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: