Provider Demographics
NPI:1235117821
Name:SLOAN, CYNTHIA A (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:SLOAN
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:PO BOX 9261
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-9261
Mailing Address - Country:US
Mailing Address - Phone:940-764-5350
Mailing Address - Fax:940-764-7255
Practice Address - Street 1:4327 BARNETT RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2303
Practice Address - Country:US
Practice Address - Phone:940-764-5350
Practice Address - Fax:940-764-5351
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK67142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148688801Medicaid
TX148688801Medicaid
TXG80171Medicare UPIN
TX8005B0Medicare ID - Type Unspecified