PREMIER GENERAL AND COLORECTAL SURGERY PA
NPI 1760738207
Specialist in Shenandoah, TX

Q: What is Premier General And Colorectal Surgery, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since August 02, 2012

129 VISION PARK BLVD STE 212, SHENANDOAH, TX 77384(832) 303-2922(866) 923-1223 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Premier General And Colorectal Surgery Pa NPPES

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

PREMIER GENERAL AND COLORECTAL SURGERY PA (NPI 1760738207) is a healthcare organization registered as a specialist in Shenandoah, Texas and active in the NPI registry since August 2012. The organization lists Cindy Kim, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1760738207

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NamePREMIER GENERAL AND COLORECTAL SURGERY, PA

Location Address129 VISION PARK BLVD STE 212Shenandoah, TX 77384-3024

Mailing Address129 Vision Park Blvd Ste 212Shenandoah, TX 77384-3024 · (832) 303-2922 · Fax (866) 923-1223

Phone(832) 303-2922

Fax(866) 923-1223

Organization SubpartNo

Authorized OfficialCindy KimOffice Manager · (832) 303-2922

Enumeration DateAugust 2, 2012

Last NPPES UpdateMarch 7, 2023

NPPES CertifiedJune 15, 2022

✔ NPI 1760738207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in TX · N3791

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

129 VISION PARK BLVD STE 212, Shenandoah, TX 77384

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Other Names 1

Doing Business AsPremier General And Colorectal Surgery Pa

Other Identifiers 2

OtherK0169364Dps

OtherN3791License

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premier General And Colorectal Surgery Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Premier General And Colorectal Surgery PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Junuk Kim, MD

Colorectal Surgery (Proctology)

NPI 1497917553

129 VISION PARK BLVD STE 212
Shenandoah, TX 77384

(832) 303-2922

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Premier General And Colorectal Surgery, PA's NPI number?

The NPI number for Premier General And Colorectal Surgery, PA is 1760738207. It was assigned to this organization in the NPPES registry on August 2, 2012. The provider is doing business as Premier General And Colorectal Surgery PA.

Where is Premier General And Colorectal Surgery, PA located?

Premier General And Colorectal Surgery, PA is located at 129 Vision Park Blvd Ste 212, Shenandoah, TX 77384. The listed phone number is (832) 303-2922.

What is Premier General And Colorectal Surgery, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Premier General And Colorectal Surgery, PA enrolled in Medicare?

Yes. Premier General And Colorectal Surgery, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier General And Colorectal Surgery, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Colorectal Surgery (Proctology)) reassigns their Medicare billing to Premier General And Colorectal Surgery, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premier General And Colorectal Surgery, PA was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.