Basic Information
| Provider Information | |||||||||
| NPI: | 1720498041 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CYPRESS WOMEN'S CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21216 NORTHWEST FWY | ||||||||
| Address2: | SIUTE 520 | ||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774291439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819557900 | ||||||||
| FaxNumber: | 2819557900 | ||||||||
| Practice Location | |||||||||
| Address1: | 21216 NORTHWEST FWY | ||||||||
| Address2: | SIUTE 520 | ||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774291439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819557900 | ||||||||
| FaxNumber: | 2819557900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2014 | ||||||||
| LastUpdateDate: | 05/08/2014 | ||||||||
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| AuthorizedOfficialLastName: | KIRKMAN | ||||||||
| AuthorizedOfficialFirstName: | KERRY | ||||||||
| AuthorizedOfficialMiddleName: | ANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | OB/GYN | ||||||||
| AuthorizedOfficialTelephone: | 2819557900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2500X | 630726 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No ID Information.