DR. KYLE WAYNE STEPHENS (NPI# 1700084522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700084522 |
| Entity Type | Individual |
| Full Name | DR. KYLE WAYNE STEPHENS |
| Credential | MD |
| Practice Address |
2060 Space Park Dr Suite 100 Houston TX 77058-3600 |
| Practice Telephone | 2813331703 |
| Practice Fax Number | 2813335970 |
| Mailing Telephone | 2813331703 |
| Mailing Fax Number | 2813335970 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2016-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
P7575 | TX | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | P7575 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | OH | Student, Health Care | |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 0116016495 | VA | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8GD970 | 01 |
| TX | RR MEDICARE | P01355059 | 01 |
| TX | 337186601 | 05 | |
| TX | 337186602 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194364927 | Kyle D Stephens | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2019-12-26 |
| 1205204518 | Kyle Bradley Stephens | Family Medicine | 168 N Brent St Ste 502, Ventura, CA 93003-2840 | 2015-09-03 |
| 1225471022 | Kyle Jay Stephens | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # 41, Tampa, FL 33612-4742 | 2013-04-10 |
| 1407114069 | Kyle A Stephens | Behavioral Analyst | 320 Main St, Shelbyville, KY 40065-1026 | 2012-05-01 |
| 1083856009 | Kyle R. Stephens | Orthopaedic Surgery | 1004 Cornerstone Dr, Paris, TN 38242-5847 | 2009-04-06 |
| Street Address |
2060 SPACE PARK DR SUITE 100 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77058-3600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457359580 | Francoise Thomas Vandaele | Specialist | 2060 Space Park Dr, Suite 410, Houston, TX 77058-3600 | 2005-07-12 |
| 1194169912 | Gordon Bellah Jr. | Specialist | 2060 Space Park Dr, Suite 204, Houston, TX 77058-3600 | 2013-04-23 |
| 1205173614 | Sri B Gottimukkala | Obstetrics & Gynecology | 2060 Space Park Dr, Suite 410, Houston, TX 77058-3600 | 2013-01-07 |
| 1538313838 | Nadeem A Malhi Md Pa | Family Medicine | 2060 Space Park Dr, Houston, TX 77058-3600 | 2008-11-13 |
| 1225282734 | Azmat Khan Md Pa | Internal Medicine | 2060 Space Park Dr, Houston, TX 77058-3600 | 2008-11-11 |
| 1346490083 | Akhila Vijayakumar | Psychiatry & Neurology | 2060 Space Park Dr, Suite 104, Houston, TX 77058-3600 | 2008-09-30 |
| 1649457490 | Anitra Johnson Md Pa | Specialist | 2060 Space Park Dr, Suite 208, Houston, TX 77058-3600 | 2008-01-23 |
| 1851590954 | Mumtaz Suleman, M.d., P.a. | Psychiatry & Neurology | 2060 Space Park Dr, Suite 404, Houston, TX 77058-3600 | 2007-07-17 |
| 1265636831 | Gabriel H Lee | Internal Medicine | 2060 Space Park Dr, Suite 200, Houston, TX 77058-3600 | 2007-06-14 |
| 1235340589 | Venkata Samavedi | Internal Medicine | 2060 Space Park Dr, Suite 406, Houston, TX 77058-3600 | 2007-05-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699248807 | Jolly Joseph | Nurse Practitioner | 18300, Houston Methodist, Houston, TX 77058 | 2019-01-10 |
| 1700372992 | Jasmin Elise Auzenne | Audiologist | 17625 El Camino Real Ste 155, Houston, TX 77058 | 2018-07-10 |
| 1053801225 | Dialyspa Vii LLC | Clinic/Center | 1411 Bonner St., Houston, TX 77058 | 2018-05-14 |
| 1699263285 | Pneucare, LLC | Durable Medical Equipment & Medical Supplies | 1322 Space Park Dr Ste C120, Houston, TX 77058 | 2018-04-29 |
| 1972005189 | Limy Fernandus | Nurse Practitioner | 985 E Nasa Pkwy, Houston, TX 77058 | 2018-03-03 |
| 1033623616 | Sigi Paul | Nurse Practitioner | 1210 El Camino Village Dr., Houston, TX 77058 | 2017-11-19 |
| 1881107845 | Jennifer Elise Hobson | Counselor | 1322 Space Park Dr Ste B123, Houston, TX 77058 | 2017-11-13 |
| 1174035778 | Agrarian Wellness, LLC | Registered Nurse | 17000 El Camino Real Ste 209, Houston, TX 77058 | 2017-11-04 |
| 1013468073 | Cynthia Bandemer | Counselor | 17300 El Camino Real Ste 107d, Houston, TX 77058 | 2016-10-14 |
| 1043698533 | Hopewell Home Healthcare LLC | Nursing Care | 18090 Kings Row, Houston, TX 77058 | 2015-05-15 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209708 | Preva Surgical Partners Cypress LLC | Surgery | 13114 Fm 1960 Rd W Ste 118, Houston, TX 77065-5590 | 2020-09-09 |
| 1760009195 | Tomball Surgical Assistant Service LLC | Surgery | 18220 Tomball Pkwy # 249, Houston, TX 77070-4347 | 2020-07-01 |
| 1033775689 | Richard Harold Lynch | Surgery | 842 Country Ln, Houston, TX 77024-3106 | 2019-05-18 |
| 1629632260 | Vein Clinics of Texas | Surgery | 2024 Richmond Ave Ste 300, Houston, TX 77098-3424 | 2019-04-29 |
| 1063982080 | International Center for Neuroscience | Surgery | 4141 Southwest Fwy Ste 200, Houston, TX 77027-7387 | 2018-12-03 |
| 1245709344 | Mgh Surgical Care Pllc | Surgery | 10130 Louetta Rd Ste A-2, Houston, TX 77070-2118 | 2018-11-19 |
| 1275039521 | Courtney Olsen | Surgery | 1603 Tabor St, Houston, TX 77009-2516 | 2018-04-04 |
| 1972002525 | L Camp LLC | Surgery | 1725 Main St Ste 2, Houston, TX 77002-8142 | 2018-02-09 |
| 1184122939 | Nh Provider Network Pllc | Surgery | 11700 Katy Fwy Ste 300, Houston, TX 77079-1218 | 2018-01-26 |
| 1871008961 | Principle Spine and Joint Institute | Surgery | 16840 Buccaneer Ln Ste J, Houston, TX 77058-2507 | 2017-12-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.