Healthcare Provider Details

I. General information

NPI: 1669824322
Provider Name (Legal Business Name): CYPRESS PHYSICIANS GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13121 LOUETTA RD # 1170
CYPRESS TX
77429-5155
US

IV. Provider business mailing address

13121 LOUETTA RD # 1170
CYPRESS TX
77429-5155
US

V. Phone/Fax

Practice location:
  • Phone: 281-477-0525
  • Fax: 281-477-0526
Mailing address:
  • Phone: 281-477-0525
  • Fax: 281-477-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN4441
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM8346
License Number StateTX

VIII. Authorized Official

Name: RANJIT SINGH GREWAL
Title or Position: OWNER
Credential: MD
Phone: 281-477-0525