Provider Demographics
NPI:1114996303
Name:HUDE, KEVIN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:ROBERT
Last Name:HUDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2420
Mailing Address - Country:US
Mailing Address - Phone:713-800-0656
Mailing Address - Fax:713-827-1380
Practice Address - Street 1:2130 W HOLCOMBE BLVD
Practice Address - Street 2:10TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3306
Practice Address - Country:US
Practice Address - Phone:713-600-0900
Practice Address - Fax:713-600-0070
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.026300207R00000X
TXM5768207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX381208YKTUOtherMEDICARE PTAN
TX381208YKTUOtherMEDICARE PTAN