Provider Demographics
NPI:1669489704
Name:CIBOROWSKI, AMY D (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:CIBOROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1 BAYLOR PLZ STE N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-3111
Mailing Address - Fax:713-798-7999
Practice Address - Street 1:20171 CHASEWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1437
Practice Address - Country:US
Practice Address - Phone:713-798-3111
Practice Address - Fax:713-798-7999
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG4983208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121368801Medicaid
TX121368801Medicaid
E43906Medicare UPIN