MARY KIM (NPI# 1275720930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275720930 |
| Entity Type | Individual |
| Full Name | MARY KIM |
| Other Name | MARY K KRAUS |
| Credential | PA-C |
| Practice Address |
4502 Medical Dr San Antonio TX 78229-4402 |
| Mailing Address |
7703 Floyd Curl Dr San Antonio TX 78229-3901 |
| Practice Telephone | 2103584000 |
| Mailing Telephone | 2103584000 |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2017-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05485 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CSHCN | 190597803 | 01 |
| TX | 190597802 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053729467 | Mary Grace Kim | Dentist | 8321 W Golf Rd, Niles, IL 60714-1113 | 2014-07-29 |
| 1568581536 | Mary M. Kim | Optometrist | 978 Main St., S. Weymouth, MA 02190 | 2007-03-28 |
| 1902880123 | Mary M. Kim | Internal Medicine | 1624 Mars Hill Rd, Suite B, Watkinsville, GA 30677-4813 | 2005-12-01 |
| 1497301261 | Mary Suhyun Kim | Student in an Organized Health Care Education/Training Program | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2019-08-16 |
| 1861975344 | Mary Kim | Registered Nurse | 6223 N Canton Center Rd Ste 201, Canton, MI 48187-2696 | 2018-09-11 |
| 1184165516 | Mary Kim | Dentist | 251 E Huron St, Chicago, IL 60611-2908 | 2017-03-18 |
| 1730523309 | Mary E Kim | Dermatology | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2013-04-25 |
| 1790804060 | Mary Wai Ming Kim | Dentist | 1441 Kapiolani Blvd, Suite 1515, Honolulu, HI 96814 | 2007-03-28 |
| 1508998782 | Mary Ann Kim | Dentist | 233 S Wacker Dr, Lower Level 1, Chicago, IL 60606-6306 | 2007-03-12 |
| 1780724435 | Mary I Kim | Physical Medicine & Rehabilitation | 11406 Loma Linda Dr, Suite 516, Loma Linda, CA 92354-3711 | 2007-02-08 |
| Street Address |
4502 MEDICAL DR |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78229-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061017 | Sandra E Sanchez-reilly | Internal Medicine | 4502 Medical Dr, San Antonio, TX 78229 | 2005-05-27 |
| 1356959217 | Andrew Sharp | Nurse Practitioner | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-07-16 |
| 1588280895 | Juan Manuel Martinez Escallon | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-06-23 |
| 1982220331 | Gabriel Roman Souza | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-06-22 |
| 1548883689 | Sheldon Sugioka | Radiologic Technologist | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-23 |
| 1306469895 | Hrishikesh Das | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-19 |
| 1427671932 | Jacob Daniel Weston | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-19 |
| 1396368882 | Yimage Ahmed | Surgery | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-19 |
| 1376165001 | Jun Hung | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-15 |
| 1407477060 | Nicolas Alexander Morton-gonzaba | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245857226 | Lyndsey A Sandoval | Optometrist | 7400 Minton Miner St, San Antonio, TX 78229 | 2020-06-25 |
| 1295355311 | Nicolet Finger | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive, Mc 7798, San Antonio, TX 78229 | 2020-04-18 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1740822972 | Mohammad Safaie Yazdi | Student in an Organized Health Care Education/Training Program | Ut Health Science Center At San Antonio- Agdc, 8210 Floyd Curl Dr., Msc 8103, San Antonio, TX 78229 | 2019-10-09 |
| 1063053072 | Blas Edward Villa | Nurse Practitioner | 7703 Floyd Curl Drive Mc 7885 Pulmonary Diseases & Crit, Medicine, San Antonio, TX 78229 | 2019-10-01 |
| 1124673942 | Integrity Dme Services LLC | Durable Medical Equipment & Medical Supplies | 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 | 2019-08-08 |
| 1730734120 | Marisa Erin Leyden | Speech-Language Pathologist | Joe R. & Teresa Lozano Long Campus, 7703 Floyd Curl Dr., San Antonio, TX 78229 | 2019-08-03 |
| 1285295741 | Alireza Ghezavati | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive Mc 7750, Department of Pathology and Laboratory Medicine, San Antonio, TX 78229 | 2019-06-25 |
| 1407410285 | Denae Cheyenne Rushing | Student in an Organized Health Care Education/Training Program | 8201 Floyd Curl Drive, San Antonio, TX 78229 | 2019-04-26 |
| 1265993570 | Shehzad Amlani | Student in an Organized Health Care Education/Training Program | Address: 7703 Floyd Curl Dr, San Antonio, TX 78229 | 2019-03-28 |
| Find all providers in zip 78229 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1194210658 | 5 Star Integrity Healthcare, LLC | Physician Assistant | 1300 West Ave Ste 201, San Antonio, TX 78201-3501 | 2018-06-27 |
| 1245750512 | William S Beall Jr. | Physician Assistant | 230 E Travis St, San Antonio, TX 78205-1702 | 2017-06-27 |
| 1114473808 | Devon H. Durand | Physician Assistant | 7950 Floyd Curl Dr Ste 805, San Antonio, TX 78229-3926 | 2016-09-01 |
| 1538533104 | Dara Danielle Valdez | Physician Assistant | 2040 Babcock Rd Ste 301, San Antonio, TX 78229-4428 | 2015-11-19 |
| 1720458870 | Thomas Alan Espinoza | Physician Assistant | 1919 Rogers Rd Ste 104, San Antonio, TX 78251 | 2015-10-01 |
| 1477922474 | Michelle Sheree Fonseca | Physician Assistant | 9811 Huebner Rd Bldg 2, San Antonio, TX 78240-3255 | 2015-09-20 |
| 1235526575 | Precision First Assist LLC | Physician Assistant | 1141 N Loop 1604 E # 105-717, San Antonio, TX 78232-1339 | 2015-04-24 |
| 1497142160 | Jimmy Larue Conner | Physician Assistant | 2903 Deer Ledge, San Antonio, TX 78230-4554 | 2015-04-21 |
| 1740678317 | Catherine Millet | Physician Assistant | 730 N Main Ave Ste 312, San Antonio, TX 78205-1115 | 2015-01-05 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78229 |
Please comment or provide details below to improve the information on MARY KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.