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General NPI Number Information
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NPI Number | 1306832936
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Entity Type | Individual
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Provider Name | GINA E. KIM OD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 1229 CAMPBELL RD
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City | HOUSTON
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State | TX
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Zip | 77055-6401
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Country | US
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Telephone | 713-467-6600
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Fax | 713-467-7914
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Provider Business Mailing Address
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Address Line | 2855 GRAMERCY ST
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City | HOUSTON
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State | TX
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Zip | 77025-1756
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Country | US
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Telephone | 713-668-6828
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Fax | 713-558-8785
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5253T
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License Number State | TX
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