Active NPI
Mansik Kim, RCS,RVS
- Vascular Sonography Radiologic Technologist
- Houston, TX
National Provider Identifier
1629349790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Sonography Radiologic Technologist
- License
- 00074629
- Practice address
- 8831 Long Point Dr. Suite #104
Houston, TX 77055-4402 - Phone
- (713) 894-1809
- Fax
- (713) 588-1809
- NPI assigned
- Jan 22, 2012
- 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 |
|---|---|---|---|---|
| Vascular Sonography Radiologic Technologist | 2471V0105X | 00074629 | TX | Primary |
Addresses
Primary practice location
8831 Long Point Dr. Suite #104
Houston, TX 77055-4402
Mailing address
8831 Long Point Rd Ste 104
Houston, TX 77055-3010
Phone (713) 894-1809
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 |
|---|---|---|---|
| 00074629 | TX | MD | Vascular Sonography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1629349790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8831 LONG POINT RD STE 104",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770553010",
"telephone_number": "713-894-1809",
"fax_number": "713-588-1809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8831 LONG POINT DR. SUITE #104",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770554402",
"telephone_number": "713-894-1809",
"fax_number": "713-588-1809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MANSIK",
"name_prefix": "Mr.",
"credential": "RCS,RVS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-22",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "2471V0105X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Vascular Sonography",
"state": "TX",
"license": "00074629",
"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 Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.