Provider Demographics
NPI:1720423841
Name:CYPRESS SPRINGS FAMILY CARE-PEARLAND, PLLC
Entity Type:Organization
Organization Name:CYPRESS SPRINGS FAMILY CARE-PEARLAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEVONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-1400
Mailing Address - Street 1:12004 SHADOW CREEK PKWY
Mailing Address - Street 2:SUITE 121
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7326
Mailing Address - Country:US
Mailing Address - Phone:281-968-9290
Mailing Address - Fax:281-463-1432
Practice Address - Street 1:7630 FRY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3375
Practice Address - Country:US
Practice Address - Phone:281-463-1400
Practice Address - Fax:281-463-1432
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CYPRESS SPRINGS FAMILY CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04314363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty