Active NPI
Min Kim
- Pharmacist
- Round Rock, TX
National Provider Identifier
1598210965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66338
- Practice address
- 1855 Gattis School Rd
Round Rock, TX 78664-7428 - Phone
- (626) 445-1284
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 56691 | CA | |
| Pharmacist | 183500000X | 66338 | TX | Primary |
Addresses
Primary practice location
1855 Gattis School Rd
Round Rock, TX 78664-7428
Mailing address
15824 Garrison Cir
Austin, TX 78717-3005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56691 | CA | MD | Pharmacist |
| 66338 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1598210965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15824 GARRISON CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787173005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 GATTIS SCHOOL RD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786647428",
"telephone_number": "626-445-1284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "56691",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "66338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.