Active NPI
Poong Young Kim, M.D.,PH.D.
- Obstetrics & Gynecology Physician
- Houston, TX
National Provider Identifier
1366568453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- G6543
- Practice address
- 902 Frostwood Dr
Suite 178
Houston, TX 77024-2420 - Phone
- (713) 973-2550
- Fax
- (713) 973-2990
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | G6543 | TX | Primary |
Addresses
Primary practice location
902 Frostwood Dr
Suite 178
Houston, TX 77024-2420
Mailing address
902 Frostwood Dr
Suite 178
Houston, TX 77024-2420
Phone (713) 973-2550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161031001169 | TX | Order and Referring Only - Obstetrics/Gynecology | 8123306859 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G6543 | TX | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366568453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 FROSTWOOD DR",
"address_2": "SUITE 178",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242420",
"telephone_number": "713-973-2550",
"fax_number": "713-973-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 FROSTWOOD DR",
"address_2": "SUITE 178",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242420",
"telephone_number": "713-973-2550",
"fax_number": "713-973-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "POONG",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "M.D.,PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "G6543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.