Healthcare Provider Details

I. General information

NPI: 1881139533
Provider Name (Legal Business Name): CYPRESS POINTE PHYSICIANS NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42570 S AIRPORT RD
HAMMOND LA
70403-0946
US

IV. Provider business mailing address

42570 S AIRPORT RD
HAMMOND LA
70403-0946
US

V. Phone/Fax

Practice location:
  • Phone: 985-510-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: GLENDA DOBSON
Title or Position: CEO
Credential:
Phone: 985-510-6200