Provider Demographics
NPI:1689130569
Name:C.M. SPEAKS, N.P., PLLC
Entity Type:Organization
Organization Name:C.M. SPEAKS, N.P., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAKS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:903-738-5890
Mailing Address - Street 1:1202 JASMINE LN
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2836
Mailing Address - Country:US
Mailing Address - Phone:903-738-5890
Mailing Address - Fax:866-842-1649
Practice Address - Street 1:2700 S HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-4033
Practice Address - Country:US
Practice Address - Phone:903-738-5890
Practice Address - Fax:866-842-1649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700931540OtherTYPE 1 NPI