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General NPI Number Information
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NPI Number | 1629349790
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Entity Type | Individual
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Provider Name | MANSIK KIM RCS,RVS
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Gender | Male
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Dates
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Enumeration Date | 01/22/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 8831 LONG POINT DR. SUITE #104
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City | HOUSTON
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State | TX
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Zip | 77055-4402
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Country | US
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Telephone | 713-894-1809
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Fax | 713-588-1809
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Provider Business Mailing Address
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Address Line | 8831 LONG POINT RD STE 104
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City | HOUSTON
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State | TX
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Zip | 77055-3010
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Country | US
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Telephone | 713-894-1809
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Fax | 713-588-1809
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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 | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 00074629
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License Number State | TX
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