MEDICARE: BARKER CYPRESS MEDICAL CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	363LA2200X	Adult Health Nurse Practitioner
3	363LF0000X	Family Nurse Practitioner
4	363LP2300X	Primary Care Nurse Practitioner
5	363LX0106X	Occupational Health Nurse Practitioner
6	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1437490885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARKER CYPRESS MEDICAL CLINIC LLC

Provider Business Mailing Address
First Line	:	1855 BARKER CYPRESS RD
Second Line	:	STE 150
City	:	HOUSTON
State	:	TX
Zip	:	77084-7209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1855 BARKER CYPRESS RD
Second Line	:	STE 150
City	:	HOUSTON
State	:	TX
Zip	:	77084-7209
Country	:	US
Telephone Number	:	281-579-9393
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	CYNTHIA NKEIRU NGWABA
Credential	:
Telephone Number	:	281-579-9393

Provider Enumeration Date	:	03/11/2013
Last Update Date	:	03/11/2013

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