Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | M3613 | TX |
NPI | 1013024819 |
---|---|
Provider Name | Dr. Hee Won Kim |
First Address | Webster, TX 77598-4220 |
Second Address | Webster, TX 77598-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 19/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
627284 | (05) | AZ |