Provider Demographics
NPI:1235357211
Name:SCOTT, CYNTHIA GAYLE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:GAYLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-5000
Mailing Address - Country:US
Mailing Address - Phone:281-770-8645
Mailing Address - Fax:281-998-0497
Practice Address - Street 1:8307 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3905
Practice Address - Country:US
Practice Address - Phone:713-242-7707
Practice Address - Fax:713-243-3276
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX608059363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608059OtherRN
TX8D2859Medicare ID - Type Unspecified
TX608059OtherRN