Provider Demographics
NPI:1114941804
Name:HUTSON, CINDY I (DO)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:I
Last Name:HUTSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 WOLFLIN AVE # 968
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1825
Mailing Address - Country:US
Mailing Address - Phone:806-351-2000
Mailing Address - Fax:806-351-2060
Practice Address - Street 1:2703 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3330
Practice Address - Country:US
Practice Address - Phone:806-351-2000
Practice Address - Fax:806-351-2060
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3248207Q00000X
TXK2721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5541860001OtherPALMETTO DMERC
TX8F1460OtherRAILROAD MEDICARE
TX145524101OtherFIRST CARE
TX173380100OtherFIRSTCARE
TX5541860001OtherPALMETTO DMERC
TX8F1460OtherRAILROAD MEDICARE
TX178859801Medicaid
TX145524101OtherSOUTHWEST LIFE & HEALTH
TXG86053OtherUNICARE
TX5541860001OtherPALMETTO DMERC
TX8AN911OtherBCBS
TX8U5870OtherBCBS