MEDICARE: DR. JUDY EUNJOO KIM MD

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	207W00000X	Ophthalmology Physician	V0871	TX
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	V0871	TX

General Provider Information

NPI Number	:	1992756746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDY EUNJOO KIM MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-645-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD FL 6
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-4812
Country	:	US
Telephone Number	:	214-645-2020
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/16/2026

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