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General NPI Number Information
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NPI Number | 1700084522
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Entity Type | Individual
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Provider Name | KYLE WAYNE STEPHENS MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 2060 SPACE PARK DR SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77058-3600
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Country | US
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Telephone | 281-333-1703
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Fax | 281-333-5970
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Provider Business Mailing Address
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Address Line | 2060 SPACE PARK DR SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77058-3600
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Country | US
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Telephone | 281-333-1703
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Fax | 281-333-5970
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | P7575
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116016495
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P7575
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License Number State | TX
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