Provider Demographics
NPI:1720226921
Name:WILLIAM T. HARBOUR, MD
Entity Type:Organization
Organization Name:WILLIAM T. HARBOUR, MD
Other - Org Name:CYPRESS MEDICAL CLINIC, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-433-7204
Mailing Address - Street 1:18926 WILD ROSE LANE #2
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377
Mailing Address - Country:US
Mailing Address - Phone:281-433-7204
Mailing Address - Fax:281-351-4909
Practice Address - Street 1:18926 WILD ROSE LANE #2
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377
Practice Address - Country:US
Practice Address - Phone:281-433-7204
Practice Address - Fax:281-351-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2236261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOORM42Medicare PIN