Provider Demographics
NPI:1205913639
Name:FORD, CINDY LEA (PT)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LEA
Last Name:FORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2817
Mailing Address - Country:US
Mailing Address - Phone:254-562-6335
Mailing Address - Fax:254-562-6813
Practice Address - Street 1:101 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2817
Practice Address - Country:US
Practice Address - Phone:254-562-6335
Practice Address - Fax:254-562-6813
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-3030-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX650283OtherBLUE CROSS BLUE SHIELD