MEDICARE: TAE KUN KIM D.C.

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	111N00000X	Chiropractor	DC9888	TX
2	111N00000X	Chiropractor	9888	TX

General Provider Information

NPI Number	:	1568512085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAE KUN KIM D.C.

Provider Business Mailing Address
First Line	:	1908 ROYAL LN STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-0267
Country	:	US
Telephone Number	:	940-312-1448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1908 ROYAL LN STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-0267
Country	:	US
Telephone Number	:	940-312-1448
Fax Number	:

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	10/25/2024

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Directions to “ TAE KUN KIM D.C.” Practice Location

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