Healthcare Provider Details

I. General information

NPI: 1770116493
Provider Name (Legal Business Name): KYLE L GRESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

3800 RESERVOIR ROAD NW DEPT OF SURGERY
WASHINGTON DC
20007
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5000
  • Fax:
Mailing address:
  • Phone: 202-444-5022
  • Fax: 202-444-7987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: