Provider Demographics
NPI:1235418310
Name:HEIMBAUGH, CINDY GRIFFITH (PT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:GRIFFITH
Last Name:HEIMBAUGH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:GRIFFITH
Other - Last Name:BENEDICT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11937 US HIGHWAY 271
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708-3154
Mailing Address - Country:US
Mailing Address - Phone:903-877-7293
Mailing Address - Fax:903-877-5615
Practice Address - Street 1:11937 US HIGHWAY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7293
Practice Address - Fax:903-877-5615
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist