Provider Demographics
NPI:1184940397
Name:CYPRESS SPRINGS FAMILY CARE PLLC
Entity type:Organization
Organization Name:CYPRESS SPRINGS FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JALPA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:229-444-5088
Mailing Address - Street 1:7630 RUSTIC LAKE LANE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:229-444-5088
Mailing Address - Fax:270-751-0405
Practice Address - Street 1:7630 RUSTIC LAKE LANE
Practice Address - Street 2:SUITE 300
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:229-444-5088
Practice Address - Fax:270-751-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04314363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty