MEDICARE: KAY MIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	U1968	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1053992313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY MIN

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8080 INDEPENDENCE PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-4000
Country	:	US
Telephone Number	:	972-596-9511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	12/16/2025

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Directions to “ KAY MIN ” Practice Location

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