Provider Demographics
NPI:1881868735
Name:VO, KIMCUC T (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMCUC
Middle Name:T
Last Name:VO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 JONES RD.
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5265
Mailing Address - Country:US
Mailing Address - Phone:281-477-7200
Mailing Address - Fax:281-477-7289
Practice Address - Street 1:12220 JONES RD.
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5265
Practice Address - Country:US
Practice Address - Phone:281-477-7200
Practice Address - Fax:281-477-7289
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88D356OtherBCBS
TXB-18974-1OtherCHIP
TN983207OtherUNITED CONCORDIA