Provider Demographics
NPI:1083970974
Name:CYFAIR PSYCHOLOGICAL GROUP
Entity Type:Organization
Organization Name:CYFAIR PSYCHOLOGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-894-4500
Mailing Address - Street 1:15201 MASON RD STE 106
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5955
Mailing Address - Country:US
Mailing Address - Phone:281-894-4500
Mailing Address - Fax:281-894-0101
Practice Address - Street 1:11301 FALLBROOK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4237
Practice Address - Country:US
Practice Address - Phone:281-894-4500
Practice Address - Fax:281-894-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty