Provider Demographics
NPI:1417167545
Name:PLADZIEWICZ, CYNTHIA (PHD)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:PLADZIEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE STE 1155
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1911
Mailing Address - Country:US
Mailing Address - Phone:214-824-2273
Mailing Address - Fax:214-826-9340
Practice Address - Street 1:3600 GASTON AVE STE 1155
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1911
Practice Address - Country:US
Practice Address - Phone:214-824-2273
Practice Address - Fax:214-826-9340
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031270401Medicaid
TX031270401Medicaid