Provider Demographics
NPI:1447053996
Name:ST. LUKE CLINIC OF CYPRESS
Entity type:Organization
Organization Name:ST. LUKE CLINIC OF CYPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIEST
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-863-4505
Mailing Address - Street 1:18937 KZ RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-4355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18937 KZ RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4355
Practice Address - Country:US
Practice Address - Phone:979-219-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center