Provider Demographics
NPI:1275542516
Name:KIM, DANIEL HWAN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:HWAN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2070
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1541
Mailing Address - Country:US
Mailing Address - Phone:713-486-7747
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD STE 2410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2584
Practice Address - Country:US
Practice Address - Phone:713-486-7720
Practice Address - Fax:713-486-7744
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8084207T00000X
LAMD020347207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190557201Medicaid
TX190557201Medicaid
G12150Medicare UPIN
TX8K2040Medicare PIN
TX8L5936Medicare PIN
TXP00622398Medicare PIN