Angela Kim, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

T9150 Issued in TX

Practice address

8919 Oval Glass St
Conroe, TX 77304-1987

Phone

(609) 456-3492

NPI assigned

Mar 27, 2020

Reactivated

Sep 7, 2022

Last updated

Sep 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Angela Cai Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1548897531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 OVAL GLASS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8919 OVAL GLASS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041987",
            "telephone_number": "609-456-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANGELA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "deactivation_date": "2022-08-08",
        "reactivation_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T9150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "CAI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.