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HYETAE KIM, MD, PA
NPI 1396873170
Family Medicine in Odessa, TX

Active since March 01, 2007
1157 E 42ND ST, ODESSA, TX 79762(432) 550-5300(432) 687-6299 Get Directions Write a Review

NPPES record last updated: May 1, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hyetae Kim, Md, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HYETAE KIM, MD, PA (NPI 1396873170) is a healthcare organization registered as a family medicine in Odessa, Texas and active in the NPI registry since March 2007. The organization lists Chad Haggerton, Business Office Mgr., as its authorized official.

NPPES Registry Identity

NPI1396873170
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHYETAE KIM, MD, PA
Location Address1157 E 42ND STOdessa, TX 79762-7723
Mailing Address1157 E 42nd StOdessa, TX 79762-7723 · (432) 550-5300 · Fax (432) 687-6299
Phone(432) 550-5300
Fax(432) 687-6299
Organization SubpartNo
Authorized OfficialChad HaggertonBusiness Office Mgr. · (432) 550-5300
Enumeration DateMarch 1, 2007
Last NPPES UpdateMay 1, 2008
✔ NPI 1396873170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · K1852
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1157 E 42ND ST, Odessa, TX 79762
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Other Identifiers 4

Medicare UPING21363TX
Medicare PIN00264UTX
Other0017JKTX · Bcbs Group Number
Medicaid158174601TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEERTHI K MIRYALA DMD
Dentist (General Practice)
1157 E 42ND ST
ODESSA, TX 79762
Ector County (432) 242-6655
HAE RAN HELEN RHIM,MDPA
Internal Medicine (Rheumatology)
1157 E 42ND ST
ODESSA, TX 79762
Ector County (432) 550-5300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hyetae Kim, MD, PA's NPI number?

The NPI number for Hyetae Kim, MD, PA is 1396873170. It was assigned to this organization in the NPPES registry on March 1, 2007.

Where is Hyetae Kim, MD, PA located?

Hyetae Kim, MD, PA is located at 1157 E 42nd St, Odessa, TX 79762. The listed phone number is (432) 550-5300.

What is Hyetae Kim, MD, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Hyetae Kim, MD, PA was last updated on May 1, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.