Provider Demographics
NPI:1922035542
Name:THORNTON, CYNTHIA J (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MCFADDIN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2320
Mailing Address - Country:US
Mailing Address - Phone:210-543-7334
Mailing Address - Fax:210-543-7338
Practice Address - Street 1:LITTLE SPURS PEDIATRIC URGENT CARE 11398 BANDERA RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250
Practice Address - Country:US
Practice Address - Phone:210-543-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9231208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134979710Medicaid
TX8D2314Medicare ID - Type Unspecified
TX134979710Medicaid