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NPI Code Detail

MEDICARE: KYLE KIM IONM

MEDICARE: KYLE KIM IONM
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
1246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1063347441
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE KIM IONM
Provider Business Mailing Address
First Line : 2915 W BITTERS RD STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-2007
Country : US
Telephone Number : 210-598-2800
Fax Number : 210-598-4236
Provider Business Practice Location Address
First Line : 2915 W BITTERS RD STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-2007
Country : US
Telephone Number : 210-598-2800
Fax Number : 210-598-4236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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