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General NPI Number Information
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NPI Number | 1306564877
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Entity Type | Organization
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Legal Business Name | CYPRESS PT ORANGE LLC
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 3713 N 16TH ST
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City | ORANGE
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State | TX
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Zip | 77632-4630
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Country | US
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Telephone | 409-330-4005
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Fax | 409-330-4159
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Provider Business Mailing Address
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Address Line | 2034 W MAIN ST
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City | LUTCHER
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State | LA
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Zip | 70071-5364
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Country | US
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Telephone | 504-487-2336
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | GARY P BOE JR.
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Credential |
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Telephone | 504-487-2336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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