Provider Demographics
NPI:1346227816
Name:HEYNE, KIRK E (MD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:E
Last Name:HEYNE
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 1:6445 MAIN ST
Mailing Address - Street 2:OPC21
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1502
Mailing Address - Country:US
Mailing Address - Phone:713-441-9948
Mailing Address - Fax:
Practice Address - Street 1:6445 MAIN ST
Practice Address - Street 2:OPC21
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1502
Practice Address - Country:US
Practice Address - Phone:713-441-9948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1432207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122663101Medicaid
TX819841OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX122663105Medicaid
TXP01170502OtherRR MEDICARE
TX1346227816OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX264009YMVQMedicare PIN
TX122663105Medicaid
TX1346227816OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX264009YKWUMedicare PIN
TX819841Medicare PIN