MEDICARE: EUN AE KIM

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	183500000X	Pharmacist	35619	TX
2	3336C0003X	Community/Retail Pharmacy	16982	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	:	1811199193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUN AE KIM

Provider Business Mailing Address
First Line	:	6322 AIRLINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-3506
Country	:	US
Telephone Number	:	713-692-0971
Fax Number	:	713-697-5227

Provider Business Practice Location Address
First Line	:	6322 AIRLINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-3506
Country	:	US
Telephone Number	:	713-692-0971
Fax Number	:	713-697-5227

Authorized Official
Title or Position	:	OWNER
Name	:	EUN AE KIM
Credential	:	RPH
Telephone Number	:	713-692-0971

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	06/24/2008

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Directions to “EUN AE KIM ” Practice Location

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