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Organization

STANLEY H KIM, MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STANLEY H KIM MD (OWNER)
(512) 617-6767
Entity
Organization

Contact information

Practice address
12180 N MOPAC EXPY STE B, AUSTIN, TX 78758-2909
(512) 617-6767
(512) 617-5598
Mailing address
12180 N MOPAC EXPY STE B, AUSTIN, TX 78758-2909
(512) 617-6767
(512) 617-5598

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
L6472
TX
2085R0204X
Vascular & Interventional Radiology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162543601
TX
Enumeration date
09/05/2007
Last updated
07/21/2010
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