Provider Demographics
NPI:1922048644
Name:KIM, JOANNE YANG-SUN (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:YANG-SUN
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 1:925 GESSNER
Mailing Address - Street 2:SUITE 480
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-467-8491
Mailing Address - Fax:713-461-6118
Practice Address - Street 1:925 GESSNER
Practice Address - Street 2:SUITE 480
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2301
Practice Address - Country:US
Practice Address - Phone:713-467-8491
Practice Address - Fax:713-461-6118
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ42642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG43664Medicare UPIN
TX0076BEMedicare ID - Type Unspecified