Provider Demographics
NPI:1548823651
Name:DIABETES PLUS CLINIC PLLC
Entity type:Organization
Organization Name:DIABETES PLUS CLINIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JONGOH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-968-7003
Mailing Address - Street 1:1441 HIGHWAY 6 STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4951
Mailing Address - Country:US
Mailing Address - Phone:832-968-7003
Mailing Address - Fax:832-968-7713
Practice Address - Street 1:1441 HIGHWAY 6 STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4951
Practice Address - Country:US
Practice Address - Phone:832-968-7003
Practice Address - Fax:832-968-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty