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Individual

MIN PETER KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141
Mailing address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
N0168
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1558689661
BLUE CROSS BLUE SHIELD
TX
05
216129101
TX
05
216129102
TX
01
8CJ565
BCBS
TX
01
P00936712
MEDICARE RR
TX
01
P01120347
RR MEDICARE
TX
Enumeration date
05/13/2010
Last updated
01/17/2017
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