Gong, Alice Kim

Gong, Alice Kim is an individual health care provider with primary practice located at 4502 Medical Dr Fl 5 , San Antonio TX 78229-4402. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Gong, Alice Kim can be contacted via phone (210) 257-1400.

Contact Information

Primary practice address
4502 Medical Dr Fl 5 San Antonio TX 78229-4402
Phone: (210) 257-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X G9104 Texas

Profile Details

NPI number 1114034113
LBN Legal business name Gong, Alice Kim
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jul 13th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114034113 NPPES
Texas MEDICAID 103027201

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