Provider Demographics
NPI:1346979291
Name:PRIME HEALTHCARE OF CYPRESS LLC
Entity Type:Organization
Organization Name:PRIME HEALTHCARE OF CYPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HERMANJEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-387-4007
Mailing Address - Street 1:16700 HOUSE & HAHL RD
Mailing Address - Street 2:BUILDING 8A
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:832-260-8969
Mailing Address - Fax:
Practice Address - Street 1:16700 HOUSE & HAHL ROAD BUILDING 8A
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:832-387-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty