Provider Demographics
NPI:1376863092
Name:TATE, CYNTHIA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:TATE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:SALINAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:694 HILL COUNTRY DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6078
Practice Address - Country:US
Practice Address - Phone:830-792-3434
Practice Address - Fax:830-257-5875
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653708363LF0000X
TXAP119078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01547609OtherRAILROAD MEDICARE
TX335584402Medicaid
TX335584402Medicaid