Provider Demographics
NPI:1205959624
Name:ALVIS, CYNTHIA LYNNE I (PT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LYNNE
Last Name:ALVIS
Suffix:I
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 1:4714 MILL XING W
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3681
Mailing Address - Country:US
Mailing Address - Phone:817-723-7003
Mailing Address - Fax:817-498-3339
Practice Address - Street 1:4714 MILL XING W
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3681
Practice Address - Country:US
Practice Address - Phone:817-498-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1028496225100000X, 2251P0200X, 2251N0400X
10284962251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics