MEDICARE: DR. TAE KYONG KIM DC

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	13459	TX

General Provider Information

NPI Number	:	1831603067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAE KYONG KIM DC

Provider Business Mailing Address
First Line	:	25807 WESTHEIMER PKWY STE 270
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5342
Country	:	US
Telephone Number	:	281-347-4444
Fax Number	:	281-347-4445

Provider Business Practice Location Address
First Line	:	25807 WESTHEIMER PKWY STE 270
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5342
Country	:	US
Telephone Number	:	281-347-4444
Fax Number	:	281-347-4445

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

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	08/23/2024

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Directions to “ DR. TAE KYONG KIM DC” Practice Location

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