Provider Demographics
NPI:1710299235
Name:CYPRESSWOOD PHARMACY
Entity Type:Organization
Organization Name:CYPRESSWOOD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-251-0600
Mailing Address - Street 1:16116 STUEBNER AIRLINE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7327
Mailing Address - Country:US
Mailing Address - Phone:281-251-0600
Mailing Address - Fax:281-251-0617
Practice Address - Street 1:16116 STUEBNER AIRLINE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7327
Practice Address - Country:US
Practice Address - Phone:281-251-0600
Practice Address - Fax:281-251-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX269413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy