Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | J0004 | TX |
NPI | 1184652828 |
---|---|
Provider Name | Dr. Kim Thinh Hovanky |
First Address | Georgetown, TX 78626-7554 |
Second Address | Georgetown, TX 78626-7554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 07/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F77545 | (02) | TX |