Provider Demographics
NPI:1275686255
Name:ATES, CYNTHIA TAYLOR (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:TAYLOR
Last Name:ATES
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 PECOS CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2900
Mailing Address - Country:US
Mailing Address - Phone:469-971-3830
Mailing Address - Fax:888-607-7170
Practice Address - Street 1:4601 MEDICAL CENTER DR STE A&C-1
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1771
Practice Address - Country:US
Practice Address - Phone:469-971-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1951642-02Medicaid