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General NPI Number Information
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NPI Number | 1174534929
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Entity Type | Organization
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Legal Business Name | CYPRESSWOOD CLINIC ASSOCIATES
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5990 AIRLINE DR STE 160
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City | HOUSTON
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State | TX
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Zip | 77076-4233
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Country | US
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Telephone | 713-695-9947
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Fax | 713-695-8053
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Provider Business Mailing Address
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Address Line | PO BOX 111849
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City | HOUSTON
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State | TX
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Zip | 77293-0849
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Country | US
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Telephone | 713-695-9947
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Fax | 713-695-8053
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Authorized Official
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Title or Position | MANAGER
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Name | MS. KOKI SHAH
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Credential |
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Telephone | 713-699-6202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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