Individual
DR. KYLE WAYNE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2060 SPACE PARK DR, SUITE 100, HOUSTON, TX 77058-3600
(281) 333-1703
(281) 333-5970
Mailing address
2060 SPACE PARK DR, SUITE 100, HOUSTON, TX 77058-3600
(281) 333-1703
(281) 333-5970
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
P7575
TX
208600000X
Surgery Physician
Primary
P7575
TX
390200000X
Student in an Organized Health Care Education/Training Program
0116016495
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337186601
—
TX
05
—
337186602
—
TX
01
—
8GD970
BCBS
TX
01
—
P01355059
RR MEDICARE
TX
Enumeration date
07/03/2007
Last updated
11/28/2016
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