Provider Demographics
NPI:1649731167
Name:ANDERSON-MADUEKE, CYNTHIA (PMHNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ANDERSON-MADUEKE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 WESTHEIMER ROAD SUITE 300
Mailing Address - Street 2:#1040
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042
Mailing Address - Country:US
Mailing Address - Phone:707-720-9289
Mailing Address - Fax:
Practice Address - Street 1:9801 WESTHEIMER RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3979
Practice Address - Country:US
Practice Address - Phone:832-449-8973
Practice Address - Fax:707-203-8184
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX962613163W00000X
TX1129495363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse