Healthcare Provider Details

I. General information

NPI: 1336762186
Provider Name (Legal Business Name): KONNER CUE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19600 E 39TH ST S
INDEPENDENCE MO
64057-2301
US

IV. Provider business mailing address

22999 HIGHWAY 59 N
KINGWOOD TX
77339-4412
US

V. Phone/Fax

Practice location:
  • Phone: 816-698-7000
  • Fax:
Mailing address:
  • Phone: 281-348-3320
  • Fax: 281-295-5214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2024021026
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: