Provider Demographics
NPI:1174008528
Name:ELIZONDO, CYNTHIA LIZBETH
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LIZBETH
Last Name:ELIZONDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N. CYNTHIA ST.
Mailing Address - Street 2:MCALLEN
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-631-2265
Mailing Address - Fax:
Practice Address - Street 1:600 N CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8702
Practice Address - Country:US
Practice Address - Phone:956-631-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist