Provider Demographics
NPI:1609837293
Name:HUBKOVA, TEREZA (MD)
Entity Type:Individual
Prefix:
First Name:TEREZA
Middle Name:
Last Name:HUBKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 W 165TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3021
Mailing Address - Country:US
Mailing Address - Phone:913-632-3550
Mailing Address - Fax:
Practice Address - Street 1:7840 W 165TH ST STE 110
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3021
Practice Address - Country:US
Practice Address - Phone:913-632-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204004207R00000X
KS0442729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1060949OtherAETNA
MA5605169OtherCIGNA
MAAA45958OtherHARVARD PILGRIM
MA43040OtherCHILDRENS MED SECURITY
MA204004OtherCONNECTICARE
MA2110105Medicaid
MA486877OtherTUFTS
MA37169OtherHEALTH NEW ENGLAND
MAJ23821OtherBCBS MA
MA000000031444OtherBMC
H29422Medicare UPIN
A31906Medicare ID - Type Unspecified