Individual
DR. PETER YEON-SEONG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08260900
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
N5778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216204201
—
TX
01
—
216204202
CSHCN MEDICAID
TX
Enumeration date
11/20/2007
Last updated
06/25/2021
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