Provider Demographics
NPI:1457638355
Name:TRONCOSO, CYNTHIA (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:TRONCOSO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21577 DUKE ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1762
Mailing Address - Country:US
Mailing Address - Phone:210-639-0144
Mailing Address - Fax:
Practice Address - Street 1:21577 DUKE ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1762
Practice Address - Country:US
Practice Address - Phone:106-390-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT48022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer