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Organization
CYPRESS SURGERY CENTER LLC
Active
Organization
CYPRESS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
9300 E 29TH ST N, SUITE 100, WICHITA, KS 67226-2182
(316) 634-0404
(316) 634-2995
Mailing address
PO BOX 26168, OKLAHOMA CITY, OK 73126-0168
(316) 634-0404
(316) 634-2995
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S087014
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100387620A
—
KS
01
—
1512
FEDERAL BLUE CROSS
KS
01
—
490004999
RAILROAD MEDICARE
KS
Enumeration date
05/18/2006
Last updated
03/01/2023
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