Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | M3614 | TX |
NPI | 1285657239 |
---|---|
Provider Name | Dr. Jeffrey Joongmyung Kim |
First Address | Houston, TX 77046-0297 |
Second Address | Houston, TX 77030-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |