Individual
MS. JISOOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 FM 119, SUNRAY, TX 79086-2013
(806) 935-1503
(806) 935-1429
Mailing address
PO BOX 195, DUMAS, TX 79029-0195
(817) 372-4194
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1059809
TX
Other
Enumeration date
11/30/2021
Last updated
05/03/2025
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