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NPI Code Detail

MEDICARE: KIM HA

MEDICARE: KIM HA
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
1363LF0000XFamily Nurse PractitionerF01220662TX

General Provider Information

NPI Number : 1346974672
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM HA
Provider Business Mailing Address
First Line : 709 STADIUM DR
Second Line :
City : GARLAND
State : TX
Zip : 75040-4626
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3475 COLLINS BLVD
Second Line :
City : GARLAND
State : TX
Zip : 75044-3621
Country : US
Telephone Number : 972-530-5550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2022
Last Update Date : 07/12/2022

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Directions to “ KIM HA ” Practice Location

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