Provider Demographics
NPI:1588049324
Name:CY-FAIR BONE & JOINT, LLP
Entity type:Organization
Organization Name:CY-FAIR BONE & JOINT, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-664-2107
Mailing Address - Street 1:11800 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3840
Mailing Address - Country:US
Mailing Address - Phone:281-955-7577
Mailing Address - Fax:281-955-5875
Practice Address - Street 1:9645 BARKER CYPRESS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4107
Practice Address - Country:US
Practice Address - Phone:281-664-2107
Practice Address - Fax:281-955-5875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty