Provider Demographics
NPI:1457912446
Name:SMALLING, CYNTHIA DIANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DIANN
Last Name:SMALLING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 LBJ FWY STE 380
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6370
Mailing Address - Country:US
Mailing Address - Phone:972-532-7314
Mailing Address - Fax:214-351-1122
Practice Address - Street 1:5930 LBJ FWY STE 380
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6370
Practice Address - Country:US
Practice Address - Phone:972-532-7314
Practice Address - Fax:214-351-1122
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136002363LF0000X
TXAPI136002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP136002OtherSTATE LICENSE