Provider Demographics
NPI:1770036626
Name:GROVES, CYNTHIA JANELL (FNP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JANELL
Last Name:GROVES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 ASTORIA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6155
Mailing Address - Country:US
Mailing Address - Phone:281-464-8484
Mailing Address - Fax:281-464-8432
Practice Address - Street 1:11920 ASTORIA BLVD
Practice Address - Street 2:SUITE # 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089
Practice Address - Country:US
Practice Address - Phone:281-464-8484
Practice Address - Fax:281-464-8432
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily