Provider Demographics
NPI:1720008295
Name:HRABIK, BRENT A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:A
Last Name:HRABIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRENT
Other - Middle Name:A
Other - Last Name:HRABIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6675 HOLMES RD STE 360
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1167
Mailing Address - Country:US
Mailing Address - Phone:816-276-7600
Mailing Address - Fax:816-276-7992
Practice Address - Street 1:6675 HOLMES RD STE 360
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1167
Practice Address - Country:US
Practice Address - Phone:816-276-7600
Practice Address - Fax:816-276-7992
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23129207Q00000X
MO36938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103268OtherBC/BS OF KANSAS
KS175244OtherCOVENTRY INSURANCE
KS04-23129OtherSTATE MEDICAL LICENSE
KS109954OtherHPK
KS100370580CMedicaid
KS100370580CMedicaid
KS103268Medicare ID - Type Unspecified
KS100370580CMedicaid