Provider Demographics
NPI:1851556633
Name:EJIMADU, CYNTHIA ANN
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:EJIMADU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9896 BISSONNET ST STE 155
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8104
Mailing Address - Country:US
Mailing Address - Phone:281-948-4250
Mailing Address - Fax:281-929-0811
Practice Address - Street 1:9896 BISSONNET ST # 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8104
Practice Address - Country:US
Practice Address - Phone:281-948-4250
Practice Address - Fax:281-929-0811
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor