Provider Demographics
NPI:1194885798
Name:HOUCHENS, BRYAN K (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:K
Last Name:HOUCHENS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 E HELEN ST
Mailing Address - Street 2:
Mailing Address - City:HERINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67449-1606
Mailing Address - Country:US
Mailing Address - Phone:785-258-2207
Mailing Address - Fax:785-258-3535
Practice Address - Street 1:1005 N B ST
Practice Address - Street 2:
Practice Address - City:HERINGTON
Practice Address - State:KS
Practice Address - Zip Code:67449-1600
Practice Address - Country:US
Practice Address - Phone:785-258-5130
Practice Address - Fax:785-258-5129
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200635530AMedicaid
KS014053023Medicare PIN