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General NPI Number Information
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NPI Number | 1114948999
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Entity Type | Individual
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Provider Name | JIN KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 605 HOLDERRIETH BLVD
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City | TOMBALL
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State | TX
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Zip | 77375-6445
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Country | US
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Telephone | 281-401-7695
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 ISLA VISTA CT
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City | HOUSTON
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State | TX
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Zip | 77041-6056
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Country | US
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Telephone | 832-566-1976
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Fax | 832-467-3321
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K9825
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License Number State | TX
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