Individual
KYLE COSTENBADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 FANNIN ST STE 470, HOUSTON, TX 77030-2608
(631) 219-6531
Mailing address
6701 FANNIN ST STE 470, HOUSTON, TX 77030-2608
(832) 824-7237
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
W5302
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD493781
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
04/24/2026
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