Provider Demographics
NPI:1336173244
Name:MALOWITZ, CYNTHIA (ANP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MALOWITZ
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 18450
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78480
Mailing Address - Country:US
Mailing Address - Phone:361-937-2121
Mailing Address - Fax:361-937-2123
Practice Address - Street 1:9929 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 109
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5164
Practice Address - Country:US
Practice Address - Phone:361-937-2121
Practice Address - Fax:361-937-2123
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX640742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ69260Medicare UPIN
TX8G5490Medicare PIN