MEDICARE: SUNGHEE 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	39372	TX

General Provider Information

NPI Number	:	1962003442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNGHEE KIM

Provider Business Mailing Address
First Line	:	2900 WINDING PATH WAY
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-5361
Country	:	US
Telephone Number	:	214-277-2049
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 WINDING PATH WAY
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-5361
Country	:	US
Telephone Number	:	214-277-2049
Fax Number	:

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

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	11/03/2020

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Directions to “ SUNGHEE KIM ” Practice Location

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