Provider Demographics
NPI:1770975252
Name:CALVILLO, CYNTHIA ANN (FNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:CALVILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6835 WALNUT VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78242-6606
Mailing Address - Country:US
Mailing Address - Phone:210-788-6178
Mailing Address - Fax:
Practice Address - Street 1:227 N LOOP 1604 E STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:866-456-7968
Practice Address - Fax:866-456-0509
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126646363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner