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NPI Code Detail

MEDICARE: MS. MIRAE RACHEL KIM NP-C

MEDICARE: MS. MIRAE RACHEL KIM NP-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
1363LF0000XFamily Nurse PractitionerAP127598TX

Other Identifiers

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

General Provider Information

NPI Number : 1588058432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MIRAE RACHEL KIM NP-C
Provider Business Mailing Address
First Line : 5420 DASHWOOD DR STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77081-5333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 915 GESSNER RD STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77024-2537
Country : US
Telephone Number : 713-242-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2015
Last Update Date : 09/17/2024

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