Provider Demographics
NPI:1528538303
Name:WOODLEY, CINDY LINN (PTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LINN
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 RUGBY
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5003
Mailing Address - Country:US
Mailing Address - Phone:903-871-2789
Mailing Address - Fax:
Practice Address - Street 1:815 RUGBY
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-5003
Practice Address - Country:US
Practice Address - Phone:903-871-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2065546225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant