Provider Demographics
NPI:1245258375
Name:AIRHART, CYNTHIA M (DC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:AIRHART
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 SAM HOUSTON DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2233
Mailing Address - Country:US
Mailing Address - Phone:361-579-9325
Mailing Address - Fax:361-579-9328
Practice Address - Street 1:3506 SAM HOUSTON DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2233
Practice Address - Country:US
Practice Address - Phone:361-579-9325
Practice Address - Fax:361-579-9328
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7155TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0387680-02Medicaid
TX606244OtherBLUE CROSS BLUE SHIELD
TXU73369Medicare UPIN
TX0387680-02Medicaid