MEDICARE: DR. JOSEPH YUN KIM MD

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	207P00000X	Emergency Medicine Physician	T2654	TX

General Provider Information

NPI Number	:	1497067490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH YUN KIM MD

Provider Business Mailing Address
First Line	:	21750 HARDY OAK BLVD STE 104
Second Line	:	PMB 55116
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4946
Country	:	US
Telephone Number	:	615-429-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3095 KINGSWOOD BLVD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4512
Country	:	US
Telephone Number	:	972-854-0009
Fax Number	:

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

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	02/03/2026

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