Most Relevant Information
Provider Data
| NPI Number: | 1003376013 |
| Provider Name: | JITAE ALEXANDER KIM |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/25/2019 |
| Last Updated: | 03/26/2019 |
Provider Practice Location
1 BAYLOR PLZ STE 405A
HOUSTON
TX
770303411
Practice Location Phone/Fax
| Phone: | 7137985928 |
| Fax: |
Provider Mailing Location
1 BAYLOR PLZ STE 405A
HOUSTON
TX
770303411
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |