Provider Demographics
NPI:1619941366
Name:SHUGHRUE, CYNTHIA L (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:SHUGHRUE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 WALNUT HILL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3816
Mailing Address - Country:US
Mailing Address - Phone:214-363-5660
Mailing Address - Fax:214-373-7030
Practice Address - Street 1:8440 WALNUT HILL LN STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3816
Practice Address - Country:US
Practice Address - Phone:214-363-5660
Practice Address - Fax:214-737-3703
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA67652Medicare UPIN