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General NPI Number Information
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NPI Number | 1053510073
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Entity Type | Individual
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Provider Name | KIM O LEARNED MD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 1515 HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-792-6161
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 4439
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City | HOUSTON
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State | TX
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Zip | 77210-4439
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Country | US
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Telephone | 713-792-2991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD434150
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M7361
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License Number State | TX
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