Provider Demographics
NPI:1932127461
Name:SMITH, CYNTHIA KAY (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STOP 7260
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-7260
Practice Address - Country:US
Practice Address - Phone:806-743-1810
Practice Address - Fax:806-743-1335
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN4112208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX058721404Medicaid
G33776Medicare UPIN
TX058721404Medicaid