Individual
CHARLES KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-0002
(806) 743-3004
Mailing address
906 MILWAUKEE AVE APT 609, LUBBOCK, TX 79416-5965
(305) 984-4186
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12344
ND
390200000X
Student in an Organized Health Care Education/Training Program
BP10032227
TX
Other
Enumeration date
06/24/2008
Last updated
01/20/2022
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