Individual ProviderMin Peter KimThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansPractice Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717(713) 441-5141PECOS EnrollmentThis provider is enrolled in PECOS as MIN KIM.Based on the most recent information from CMS, provider Min Peter Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558689661Provider TypeIndividualFull NameKim, Min PeterCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/13/2010Last Updated1/17/2017Contact InformationPractice LocationPractice Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717Phone(713) 441-5141FaxUnlisted FaxMailing LocationMailing Address6550 Fannin St, Suite 1601, Houston, TX 77030-2717Phone(713) 441-5141FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208G00000XPrimaryDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicenseN0168TexasProvider IdentifiersIDDescriptionIssuerID8CJ565DescriptionOtherIssuerBCBSTexasIDP01120347DescriptionOtherIssuerRR MEDICARETexasID1558689661DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasID216129102DescriptionMedicaidIssuerUnlistedTexasID216129101DescriptionMedicaidIssuerUnlistedTexasIDP00936712DescriptionOtherIssuerMEDICARE RRTexas