Provider Demographics
NPI:1114936630
Name:HUETE, KENNETH N (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:N
Last Name:HUETE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 SOUTH MAIN STREET
Mailing Address - Street 2:SUITE B5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5459
Mailing Address - Country:US
Mailing Address - Phone:713-668-2225
Mailing Address - Fax:713-668-3616
Practice Address - Street 1:10021 SOUTH MAIN STREET
Practice Address - Street 2:SUITE B5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5459
Practice Address - Country:US
Practice Address - Phone:713-668-2225
Practice Address - Fax:713-668-3616
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13956Medicare UPIN
TX600829Medicare ID - Type Unspecified