Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 30347 | TX |
Y | 213EG0000X | General Practice | 30347 | TX |
NPI | 1003224684 |
---|---|
Provider Name | Dr. Sojin Kim |
First Address | Houston, TX 77005-1347 |
Second Address | Houston, TX 77039-4644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2014 |
Last Update Date | 28/07/2014 |