Provider Demographics
NPI:1861663767
Name:DAVIS, CYNTHIA T (LPT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:T
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 LOUETTA RD
Mailing Address - Street 2:118
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4351
Mailing Address - Country:US
Mailing Address - Phone:281-355-1838
Mailing Address - Fax:281-528-7441
Practice Address - Street 1:4711 LOUETTA RD
Practice Address - Street 2:118
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4351
Practice Address - Country:US
Practice Address - Phone:281-355-1838
Practice Address - Fax:281-528-7441
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T8131OtherBCBS
TX1014124OtherLICENSE
TX8T8131OtherBCBS