Individual
JESSICA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(661) 877-8602
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-8666
(210) 916-8712
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102207544
VA
208D00000X
General Practice Physician
0102207544
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/15/2021
Last updated
06/29/2025
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