Provider Demographics
NPI:1093238354
Name:CYPRESS MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:CYPRESS MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LORMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-306-8006
Mailing Address - Street 1:211 N ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-5919
Mailing Address - Country:US
Mailing Address - Phone:337-306-8006
Mailing Address - Fax:337-306-8011
Practice Address - Street 1:211 N ADAMS AVE
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-5919
Practice Address - Country:US
Practice Address - Phone:337-344-5298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty