Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | Q6859 | TX |
NPI | 1376987479 |
---|---|
Provider Name | Grace Kwang Kim |
First Address | Houston, TX 77030-3411 |
Second Address | Houston, TX 77030-2611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 08/04/2019 |