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General NPI Number Information
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NPI Number | 1033683545
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Entity Type | Organization
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Legal Business Name | J&JKIM VISION ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 2625 OLD DENTON RD STE 422
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City | CARROLLTON
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State | TX
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Zip | 75007-5140
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Country | US
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Telephone | 972-245-5099
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 INDIAN SPGS
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City | CARROLLTON
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State | TX
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Zip | 75007-6000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANE KIM
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Credential | OD
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Telephone | 469-951-2108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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