Provider Demographics
NPI:1235536673
Name:RHIM, SUNG MOON (LAC)
Entity type:Individual
Prefix:
First Name:SUNG MOON
Middle Name:
Last Name:RHIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 ALEXANDER
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2062
Mailing Address - Country:US
Mailing Address - Phone:408-781-3842
Mailing Address - Fax:
Practice Address - Street 1:27320 RANCH ROAD 12 UNIT C
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-1296
Practice Address - Country:US
Practice Address - Phone:737-260-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16347171100000X
TXAC01952171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist