Healthcare Provider Details

I. General information

NPI: 1619172293
Provider Name (Legal Business Name): KYLE LOUIS ESKUE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 WEST BELLFORT STREET STE 120
HOUSTON TX
77054-5024
US

IV. Provider business mailing address

PO BOX 421849
HOUSTON TX
77242-1849
US

V. Phone/Fax

Practice location:
  • Phone: 713-741-6677
  • Fax: 713-748-5860
Mailing address:
  • Phone: 713-559-6929
  • Fax: 713-559-6928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberN6283
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: