Individual
CARL IN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 UNIVERSITY BLVD BLDG A, ROUND ROCK, TX 78665-1032
(512) 509-0200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
(254) 724-7603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A99670
CA
2085R0202X
Diagnostic Radiology Physician
R6030
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
R6030
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A996700
—
CA
01
—
P00480248
RAILROAD MEDICARE
CA
Enumeration date
06/14/2007
Last updated
01/18/2019
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