Provider Demographics
NPI:1750563912
Name:PAVLOCK, CYNTHIA (LMSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:PAVLOCK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 NORTH FWY
Mailing Address - Street 2:SUITE 127
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-2914
Mailing Address - Country:US
Mailing Address - Phone:713-697-0776
Mailing Address - Fax:713-697-2309
Practice Address - Street 1:4625 NORTH FWY
Practice Address - Street 2:SUITE 127
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2914
Practice Address - Country:US
Practice Address - Phone:713-697-0776
Practice Address - Fax:713-697-2309
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41352104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker