Provider Demographics
NPI:1508383183
Name:HEISS, CYNTHIA JANE (PHD, RDN, LD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JANE
Last Name:HEISS
Suffix:
Gender:F
Credentials:PHD, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3467 RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2518
Mailing Address - Country:US
Mailing Address - Phone:805-766-9055
Mailing Address - Fax:
Practice Address - Street 1:3467 RIVER WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2518
Practice Address - Country:US
Practice Address - Phone:805-766-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83051133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered