Provider Demographics
NPI:1821367038
Name:MATULL, CINDI (CST-FA)
Entity Type:Individual
Prefix:
First Name:CINDI
Middle Name:
Last Name:MATULL
Suffix:
Gender:F
Credentials:CST-FA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 CARLISLE CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3078
Mailing Address - Country:US
Mailing Address - Phone:830-627-7979
Mailing Address - Fax:
Practice Address - Street 1:598 N UNION AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4136
Practice Address - Country:US
Practice Address - Phone:830-627-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131963164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse