Provider Demographics
NPI:1013313592
Name:SPURGAT, CYNTHIA (RD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SPURGAT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SARATOGA BLVD APT 433
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2268
Mailing Address - Country:US
Mailing Address - Phone:210-392-1785
Mailing Address - Fax:
Practice Address - Street 1:4901 SARATOGA BLVD APT 433
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2268
Practice Address - Country:US
Practice Address - Phone:210-392-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82197133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered