Provider Demographics
NPI:1407419138
Name:CYPRESS POINTE URGENT CARE, LLC
Entity Type:Organization
Organization Name:CYPRESS POINTE URGENT CARE, LLC
Other - Org Name:CYPRESS POINTE URGENT CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-222-5577
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-0867
Mailing Address - Country:US
Mailing Address - Phone:985-222-5577
Mailing Address - Fax:
Practice Address - Street 1:19065 DR. JOHN LAMBERT DRIVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-222-5577
Practice Address - Fax:985-222-3532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care