Provider Demographics
NPI:1750336533
Name:TAWA, CYRIL B (MD)
Entity type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:B
Last Name:TAWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21212 NORTHWEST FWY STE 535
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5888
Mailing Address - Country:US
Mailing Address - Phone:832-912-6777
Mailing Address - Fax:832-912-6888
Practice Address - Street 1:21212 NORTHWEST FWY STE 535
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5888
Practice Address - Country:US
Practice Address - Phone:832-912-6777
Practice Address - Fax:832-912-6888
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9164174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147565901Medicaid
TX00656RMedicare ID - Type Unspecified