Provider Demographics
NPI:1730279472
Name:HUET, RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:HUET
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 1:6301 W 128TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-4007
Mailing Address - Country:US
Mailing Address - Phone:913-302-1981
Mailing Address - Fax:913-341-6212
Practice Address - Street 1:6301 W 128TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-4007
Practice Address - Country:US
Practice Address - Phone:913-302-1981
Practice Address - Fax:913-341-6212
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-266482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098080AMedicaid
KS362D301OtherMEDICARE PIN, PART B
KS100098080CMedicaid
KSG41593Medicare UPIN