MEDICARE: YONG SIK KIM MD PLLC

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	261QP2300X	Primary Care Clinic/Center	M1834	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578703989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YONG SIK KIM MD PLLC

Provider Business Mailing Address
First Line	:	8830 LONG POINT RD
Second Line	:	SUITE 105
City	:	HOUSTON
State	:	TX
Zip	:	77055-3034
Country	:	US
Telephone Number	:	713-932-0240
Fax Number	:	713-932-0252

Provider Business Practice Location Address
First Line	:	8945 LONG POINT RD
Second Line	:	#114
City	:	HOUSTON
State	:	TX
Zip	:	77055-3034
Country	:	US
Telephone Number	:	713-932-0240
Fax Number	:	713-932-0252

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YONG S KIM
Credential	:	M.D.
Telephone Number	:	713-932-0240

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	12/05/2013

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