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General NPI Number Information
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NPI Number | 1659622884
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Entity Type | Organization
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Legal Business Name | CYPRESS ADVANCED MEDICAL CARE, P.A
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 11455 FALLBROOK DR SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77065-4238
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Country | US
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Telephone | 832-604-7044
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Fax | 832-688-8895
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Provider Business Mailing Address
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Address Line | 11455 FALLBROOK DR SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77065-4238
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Country | US
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Telephone | 832-604-7044
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Fax | 832-688-8895
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NIRESHKUMARI VIVEKANANTHAN
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Credential | M.D.,
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Telephone | 832-604-7044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | M8404
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License Number State | TX
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