Provider Demographics
NPI:1821282658
Name:CYPRESS CARDIOLOGY, P.A.
Entity Type:Organization
Organization Name:CYPRESS CARDIOLOGY, P.A.
Other - Org Name:THOMAS L DEBAUCHE MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:DEBAUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-890-8588
Mailing Address - Street 1:11301 FALLBROOK DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4237
Mailing Address - Country:US
Mailing Address - Phone:281-890-8588
Mailing Address - Fax:281-894-0426
Practice Address - Street 1:11301 FALLBROOK DR
Practice Address - Street 2:SUITE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4237
Practice Address - Country:US
Practice Address - Phone:281-890-8588
Practice Address - Fax:281-894-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00TK07Medicare PIN