Provider Demographics
NPI:1497738926
Name:TARVER, CYNTHIA P (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:P
Last Name:TARVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:POINDEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:11454 SPACE CENTER BLVD
Practice Address - Street 2:#B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3599
Practice Address - Country:US
Practice Address - Phone:281-998-0530
Practice Address - Fax:281-998-2284
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8451207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB166198OtherMEDICARE - GROUP
TXF80874Medicare UPIN