Provider Demographics
NPI:1477908200
Name:KIM, FRANCISCO ERNESTO
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ERNESTO
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 RICHMOND AVE
Mailing Address - Street 2:2011
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6780
Mailing Address - Country:US
Mailing Address - Phone:213-222-3151
Mailing Address - Fax:
Practice Address - Street 1:5455 RICHMOND AVE
Practice Address - Street 2:2011
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6780
Practice Address - Country:US
Practice Address - Phone:213-222-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32353122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist