Provider Demographics
NPI:1487737714
Name:KIM, DAVID S (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 851978
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185
Mailing Address - Country:US
Mailing Address - Phone:214-660-2533
Mailing Address - Fax:214-660-2525
Practice Address - Street 1:929 N GALLOWAY AVE STE 220
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7413
Practice Address - Country:US
Practice Address - Phone:214-660-2533
Practice Address - Fax:214-660-2525
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK9585207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1696023-02Medicaid
TX8F0344Medicare PIN
H31851Medicare UPIN