Provider Demographics
NPI:1679681514
Name:HERMANN, CYNTHIA DEAL (MD)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DEAL
Last Name:HERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 UNION CIR # 311247
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76203-5017
Mailing Address - Country:US
Mailing Address - Phone:940-565-2771
Mailing Address - Fax:940-369-4559
Practice Address - Street 1:1800 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-565-2333
Practice Address - Fax:940-565-4559
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062406A207V00000X
TXN9454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200823000AMedicaid
IN192860FMedicare PIN
INI65642Medicare UPIN