Provider Demographics
NPI:1972786028
Name:MEDINA, CINDY KAY (WHCNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:KAY
Last Name:MEDINA
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:KAY
Other - Last Name:GALLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 650859
Mailing Address - Street 2:DEPT 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-5302
Mailing Address - Country:US
Mailing Address - Phone:409-747-6240
Mailing Address - Fax:409-747-1023
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595931363LW0102X
TXAP116290363LW0102X, 363LP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760010407OtherEIN
TX760010407OtherEIN
TX00R518Medicare PIN