Provider Demographics
NPI:1386844744
Name:KIM, MAY (MD)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 FLOWER MOUND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3440
Mailing Address - Country:US
Mailing Address - Phone:972-410-0042
Mailing Address - Fax:972-410-0044
Practice Address - Street 1:1020 FLOWER MOUND RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3440
Practice Address - Country:US
Practice Address - Phone:972-410-0042
Practice Address - Fax:972-410-0044
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-123322207Q00000X
TXP9888207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036123322Medicaid
IL256510024Medicare PIN