Provider Demographics
NPI:1053697755
Name:CYFAIR PSYCHOLOGICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:CYFAIR PSYCHOLOGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:TARVER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:281-943-9250
Mailing Address - Street 1:15201 MASON RD
Mailing Address - Street 2:SUITE 1000, PMB 133
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5954
Mailing Address - Country:US
Mailing Address - Phone:281-943-9250
Mailing Address - Fax:281-894-4500
Practice Address - Street 1:11811 FM 1960 RD W
Practice Address - Street 2:SUITE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3827
Practice Address - Country:US
Practice Address - Phone:281-943-9250
Practice Address - Fax:281-894-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1174768295OtherNPI NPPES