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General NPI Number Information
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NPI Number | 1336937937
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Entity Type | Individual
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Provider Name | MINSU KIM PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1000 E SANDY LAKE RD
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City | COPPELL
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State | TX
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Zip | 75019-3111
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Country | US
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Telephone | 972-304-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 GRAPEVINE MILLS PKWY APT 824
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City | GRAPEVINE
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State | TX
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Zip | 76051-1913
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Country | US
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Telephone | 502-751-7163
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 75569
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License Number State | TX
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