Individual
ELIZABETH CARROLL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6513 PRESTON RD, PLANO, TX 75024-2688
(972) 608-2025
Mailing address
6513 PRESTON RD, PLANO, TX 75024-2688
(972) 608-2025
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
N5157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0022849
INSTITUTIONAL PERMIT
—
01
—
N5157
TEXAS MEDICAL BOARD
TX
Enumeration date
06/13/2007
Last updated
01/25/2012
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