Organization Active NPI

Eun Ae Kim

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1811199193
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
16982 Issued in TX
Legal business name
EUN AE KIM
Practice address
6322 Airline Dr
Houston, TX 77076-3506
Phone
(713) 692-0971
Fax
(713) 697-5227
NPI assigned
May 31, 2007
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Eun Ae Kim, RPH
Title
Owner
Phone
(713) 692-0971

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 35619 TX
Community/Retail Pharmacy 3336C0003X 16982 TX Primary

Addresses

Primary practice location

6322 Airline Dr
Houston, TX 77076-3506

Mailing address

6322 Airline Dr
Houston, TX 77076-3506
Phone (713) 692-0971

Other identifiers 1

IdentifierTypeStateIssuer
144417MedicaidTX

National Provider Directory

National Provider Directory

Locations

6322 Airline Dr
Houston, TX 77076
Phone (713) 692-0971

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1811199193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 AIRLINE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770763506",
            "telephone_number": "713-692-0971",
            "fax_number": "713-697-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 AIRLINE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770763506",
            "telephone_number": "713-692-0971",
            "fax_number": "713-697-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUN AE KIM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "EUN",
        "authorized_official_middle_name": "AE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-692-0971",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "35619",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "16982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144417",
            "state": "TX"
        }
    ],
    "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 Jun 24, 2008; 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.