Provider Demographics
NPI:1639338932
Name:CYNTHIA BLIZZARD MD PLLC
Entity Type:Organization
Organization Name:CYNTHIA BLIZZARD MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLIZZARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-956-7663
Mailing Address - Street 1:10706 BEINHORN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3121
Mailing Address - Country:US
Mailing Address - Phone:713-956-7663
Mailing Address - Fax:
Practice Address - Street 1:6720 BERTNER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:832-355-2628
Practice Address - Fax:832-355-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8006207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0043RLOtherBCBS
TX199079801Medicaid
TX00Z390Medicare PIN