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NPI Code Detail

MEDICARE: ARIELLE KIM PA-C

MEDICARE: ARIELLE KIM PA-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
1246Z00000XOther Specialist/Technologist3131TX
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1891182317
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIELLE KIM PA-C
Provider Business Mailing Address
First Line : 6020 W PARKER RD STE 200
Second Line :
City : PLANO
State : TX
Zip : 75093-8172
Country : US
Telephone Number : 972-608-5000
Fax Number :
Provider Business Practice Location Address
First Line : 6020 W PARKER RD STE 200
Second Line :
City : PLANO
State : TX
Zip : 75093-8172
Country : US
Telephone Number : 972-608-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2015
Last Update Date : 10/26/2020

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Directions to “ ARIELLE KIM PA-C” Practice Location

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