Provider Demographics
NPI:1699854281
Name:GARGES, KIM J (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:J
Last Name:GARGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:18100 ST JOHN DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3653
Mailing Address - Country:US
Mailing Address - Phone:281-333-2727
Mailing Address - Fax:281-333-2828
Practice Address - Street 1:18100 ST JOHN DR
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3653
Practice Address - Country:US
Practice Address - Phone:281-333-2727
Practice Address - Fax:281-333-2828
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
174400000X
TXK9782207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110749203Medicaid
TX110749203Medicaid