Individual provider Active NPI

Kyu Young Kim, MD

  • Emergency Medicine Physician
  • Seguin, TX
National Provider Identifier
1821010042
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L6470 Issued in TX
Practice address
1215 E Court St
Seguin, TX 78155-5129
Phone
(830) 379-2411
NPI assigned
Jul 24, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L6470 TX Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X L6470 TX

Addresses

Primary practice location

1215 E Court St
Seguin, TX 78155-5129

Mailing address

8839 Lost BND
San Antonio, TX 78240-4929

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000848 TX Practitioner - Emergency Medicine 3971575721 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L6470TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Round Table Physicians Group PLLC Emergency Medical Services CurrentSince Jan 22, 2024 Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Round Table Specialist Group, PLLC Emergency Medicine Current Accepting new patients
Montefiore Medical Center Emergency Medicine Past Accepting new patients

Locations

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

21214 Northwest Fwy
Cypress, TX 77429
Phone (832) 912-3500

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

11103 Westheimer Rd
Houston, TX 77042
Phone (832) 708-3651

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1821010042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8839 LOST BND",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-379-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYU",
        "middle_name": "YOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L6470",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "L6470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.