Organization Active NPI

Physician Medical Spa & Laser Center PA.

Doing business as Cypress Clinic

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1265643555
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PHYSICIAN MEDICAL SPA & LASER CENTER PA.
Doing business as
Cypress Clinic
Practice address
11811 FM 1960 Rd W
Ste.198
Houston, TX 77065-3827
Phone
(281) 469-4000
Fax
(281) 469-4126
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Rafat Tajwar, B.S.
Title
Billing Supervisor
Phone
(281) 469-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

11811 FM 1960 Rd W
Ste.198
Houston, TX 77065-3827

Mailing address

11811 FM 1960 Rd W
Ste.198
Houston, TX 77065-3827
Phone (281) 469-4000

Other names 1

  • Cypress Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

11811 FM 1960 Rd W
Ste 198
Houston, TX 77065
Phone (281) 469-4000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1265643555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 FM 1960 RD W",
            "address_2": "STE.198",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653827",
            "telephone_number": "281-469-4000",
            "fax_number": "281-469-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 FM 1960 RD W",
            "address_2": "STE.198",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653827",
            "telephone_number": "281-469-4000",
            "fax_number": "281-469-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN MEDICAL SPA & LASER CENTER PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "TAJWAR",
        "authorized_official_first_name": "RAFAT",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "281-469-4000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cypress Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.