Provider Demographics
NPI:1174019889
Name:HO, KIM THI
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:THI
Last Name:HO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIM LOAN
Other - Middle Name:THI
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, DAOM
Mailing Address - Street 1:12345 JONES RD STE 265
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4960
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12345 JONES RD STE 265
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4960
Practice Address - Country:US
Practice Address - Phone:832-408-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist