We are required by law to maintain the privacy of your health information. This notice describes how health information about you may be used and disclosed and how you can get access to this information.

We have the right to change this notice at any time, provided law permits such changes.

Your Rights...

  • You have a right to obtain a copy of this notice.
  • You have the right to obtain a copy of your billing record.
  • You may give us written authorization to disclose your payment information to anyone for any purpose.
  • You have the right to limit the health/payment information about you to someone who is involved in your care or payment of your care. For example: you may not want your son to know what a charge is for.
  • You have the right to file a complaint with our Privacy Officer if you feel your rights have been violated. See Complaint Information at the end of this notice.

Uses and Disclosures...

  • We may use and disclose health information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer. For example: we may need to give your insurance company information about a treatment or procedure so they will pay us or reimburse you for such.
  • We may disclose health/payment information for law enforcement purposes as required by law or in response to a valid subpoena.

Our Responsibilities...

  • We are required by law to maintain the confidentially and privacy of your health/payment information.
  • We are required by law to make this notice available upon request.

Complaints can be made to:

  • Office Manager: Mary Rittenberry
  • Claims Manager: Katherine King
  • Privacy Officer: Elizabeth Beard


21216 Northwest Freeway, Su.640
Cypress, Texas 77429
Office: 281-517-0262
Fax: 281-517-0263