Provider Demographics
NPI:1366681975
Name:MALVEAUX, CYNTHIA MARIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MARIA
Last Name:MALVEAUX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-4346
Mailing Address - Country:US
Mailing Address - Phone:409-770-3085
Mailing Address - Fax:
Practice Address - Street 1:516 AVENUE C
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-4346
Practice Address - Country:US
Practice Address - Phone:409-770-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572718163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse