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General NPI Number Information
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NPI Number | 1346828225
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Entity Type | Organization
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Legal Business Name | DR KIM DERMATOLOGY PLLC
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 4645 AVON LN STE 375
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City | FRISCO
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State | TX
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Zip | 75033-1216
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Country | US
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Telephone | 469-922-3376
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Fax | 469-922-3222
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Provider Business Mailing Address
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Address Line | 4645 AVON LN STE 375
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City | FRISCO
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State | TX
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Zip | 75033-1216
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Country | US
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Telephone | 469-922-3376
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Fax | 469-922-3222
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Authorized Official
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Title or Position | MD/OWNER
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Name | KIMBERLY BILLET
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Credential | MD
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Telephone | 469-922-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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