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Kenneth K Liao

Thoracic Surgery (Cardiothoracic Vascular Surgery)

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH LIAO.

Based on the most recent information from CMS, provider Kenneth K Liao is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1417053869
Provider Type
Individual
Full Name
Liao, Kenneth K
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
9/15/2006
Last Updated
5/3/2022

Contact Information

Practice Location

1101 Bates Ave, Houston, TX 77030-2607

(713) 798-1300

Unlisted Fax

Mailing Location

7200 Cambridge St, Houston, TX 77030-4202

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208G00000X Primary	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License S6233 Texas
Code 208600000X	Description Surgery Allopathic & Osteopathic Physicians	License 42328 Minnesota
Code 208G00000X	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License 42328 Minnesota

Provider Identifiers

ID	Description	Issuer
ID 0554584	Description Medicaid	Issuer Unlisted Iowa
ID 506360	Description Other	Issuer FAIRVIEW Minnesota
ID 18-00070	Description Other	Issuer MEDICA CHOICE Minnesota
ID 142142	Description Other	Issuer UCARE Minnesota
ID 224A2LI	Description Other	Issuer BLUE CROSS BLUE SHIELD Minnesota
ID 090474100	Description Medicaid	Issuer Unlisted Minnesota
ID 18-00014	Description Other	Issuer MEDICA PRIMARY Minnesota
ID HP40342	Description Other	Issuer HEALTH PARTNERS Minnesota
ID 1031690	Description Other	Issuer PREFERRED ONE Minnesota
ID 34260200	Description Medicaid	Issuer Unlisted Wisconsin

Kenneth K Liao

PECOS Enrollment

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