Provider Demographics
NPI:1023321247
Name:CYFAIR CLINIC, PA
Entity type:Organization
Organization Name:CYFAIR CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GURNAIB
Authorized Official - Middle Name:S
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-664-0093
Mailing Address - Street 1:21212 NORTHWEST FWY STE 335
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5886
Mailing Address - Country:US
Mailing Address - Phone:281-664-0093
Mailing Address - Fax:281-664-0094
Practice Address - Street 1:21212 NORTHWEST FREEWAY #335
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3373
Practice Address - Country:US
Practice Address - Phone:281-664-0093
Practice Address - Fax:281-664-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBS4245569261QM1300X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty