MEDICARE: CYPRESS PT ORANGE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1306564877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS PT ORANGE LLC

Provider Business Mailing Address
First Line	:	2034 W MAIN ST
Second Line	:
City	:	LUTCHER
State	:	LA
Zip	:	70071-5364
Country	:	US
Telephone Number	:	504-487-2336
Fax Number	:

Provider Business Practice Location Address
First Line	:	3713 N 16TH ST
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77632-4630
Country	:	US
Telephone Number	:	409-330-4005
Fax Number	:	409-330-4159

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	GARY P BOE JR.
Credential	:
Telephone Number	:	504-487-2336

Provider Enumeration Date	:	08/19/2022
Last Update Date	:	12/31/2025

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Directions to “CYPRESS PT ORANGE LLC ” Practice Location

Language	Start Address	Practice Location

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