Provider Demographics
NPI:1366118192
Name:CYPRESS SURGICARE OF TEXAS LLC
Entity type:Organization
Organization Name:CYPRESS SURGICARE OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:AVELINO
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:832-776-1134
Mailing Address - Street 1:2219 SAWDUST RD STE 1203
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2581
Mailing Address - Country:US
Mailing Address - Phone:832-776-1134
Mailing Address - Fax:832-616-3429
Practice Address - Street 1:15016 FM 529 W.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:832-776-1134
Practice Address - Fax:832-616-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty