Provider Demographics
NPI:1063507663
Name:KIM-DELIO, SOO HEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SOO HEE
Middle Name:
Last Name:KIM-DELIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SOO HEE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD STE 200D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3078
Mailing Address - Country:US
Mailing Address - Phone:512-628-1870
Mailing Address - Fax:512-628-1871
Practice Address - Street 1:1301 BARBARA JORDAN BLVD STE 200D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3078
Practice Address - Country:US
Practice Address - Phone:512-628-1870
Practice Address - Fax:512-628-1871
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11629208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics