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General NPI Number Information
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NPI Number | 1316305501
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Entity Type | Organization
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Legal Business Name | KCBS VENTURES, LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 4438 S CLACK ST
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City | ABILENE
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State | TX
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Zip | 79606-3634
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Country | US
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Telephone | 432-695-6932
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Fax | 432-695-6934
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Provider Business Mailing Address
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Address Line | PO BOX 4143
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City | MIDLAND
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State | TX
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Zip | 79704-4143
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Country | US
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Telephone | 432-695-6932
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Fax | 432-695-6934
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | MR. KYUNGHO SCOTT CHOI
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Credential | M.D., F.A.A.E.M.
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Telephone | 432-695-6932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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