Hyetae Kim, Md, Pa

LBN: Hyetae Kim, Md, Pa
Hyetae Kim, Md, Pa is an health care organization with primary practice located at 1157 E 42Nd St , Odessa TX 79762-7723. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Hyetae Kim, Md, Pa can be contacted via phone (432) 550-5300, or through Haggerton, Chad via phone (432) 550-5300.

Contact Information

Primary practice address
1157 E 42Nd St Odessa TX 79762-7723
Phone: (432) 550-5300
Fax: (432) 687-6299
Website:
Map and Directions
Authorized official contact:
Name: Haggerton, Chad
Phone: (432) 550-5300

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K1852 Texas

Profile Details

NPI number 1396873170
LBN Legal business name Hyetae Kim, Md, Pa
DBA Doing business as
Authorized official Haggerton, Chad
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2007
Last updated May 1st, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396873170 NPPES
Texas MEDICAID 158174601
Texas Other 0017JK

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