MEDICARE: KIRK E HEYNE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	G1432	TX
2	207RX0202X	Medical Oncology Physician	G1432	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01170502	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	819841	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1346227816	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1346227816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRK E HEYNE MD

Provider Business Mailing Address
First Line	:	6445 MAIN ST
Second Line	:	OPC21
City	:	HOUSTON
State	:	TX
Zip	:	77030-1502
Country	:	US
Telephone Number	:	713-441-9948
Fax Number	:

Provider Business Practice Location Address
First Line	:	6445 MAIN ST
Second Line	:	OPC21
City	:	HOUSTON
State	:	TX
Zip	:	77030-1502
Country	:	US
Telephone Number	:	713-441-9948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	03/08/2016

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Directions to “ KIRK E HEYNE MD” Practice Location

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