Provider Demographics
NPI:1508346610
Name:LAUGHLIN, CYNTHIA LOUISE
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 DOVE MDWS
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3006
Mailing Address - Country:US
Mailing Address - Phone:254-640-2003
Mailing Address - Fax:
Practice Address - Street 1:117 DOVE MDWS
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-3006
Practice Address - Country:US
Practice Address - Phone:254-640-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2024404225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant