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Individual

DR. PETER TAE WAN KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3410 WORTH ST STE 950, DALLAS, TX 75246-2064
(214) 820-2050
Mailing address
3410 WORTH ST STE 950, DALLAS, TX 75246-2064

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
N1367
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
304424001
TX
Enumeration date
07/31/2008
Last updated
11/20/2012
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