Healthcare Provider Details

I. General information

NPI: 1649594268
Provider Name (Legal Business Name): STEVEN KIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8752 MEDICAL CITY WAY STE 100
FORT WORTH TX
76177-2497
US

IV. Provider business mailing address

1521 COOPER ST
FORT WORTH TX
76104-2711
US

V. Phone/Fax

Practice location:
  • Phone: 817-284-9225
  • Fax:
Mailing address:
  • Phone: 817-336-5864
  • Fax: 817-336-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberQ7903
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberQ7903
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: