Provider Demographics
NPI:1689141087
Name:WATERS, CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2701 MATLOCK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2529
Mailing Address - Country:US
Mailing Address - Phone:817-795-8346
Mailing Address - Fax:817-717-1840
Practice Address - Street 1:2701 MATLOCK RD STE 103
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2529
Practice Address - Country:US
Practice Address - Phone:817-795-8346
Practice Address - Fax:817-717-1840
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139445363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care