Provider Demographics
NPI:1154404051
Name:CHI, CYNTHIA YVONNE (MD, MS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:YVONNE
Last Name:CHI
Suffix:
Gender:F
Credentials:MD, MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 ROANOKE RUN UNIT 11
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5200
Mailing Address - Country:US
Mailing Address - Phone:210-802-8758
Mailing Address - Fax:
Practice Address - Street 1:7914 ROANOKE RUN UNIT 11
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5200
Practice Address - Country:US
Practice Address - Phone:210-802-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85234101YP2500X
TXM1584208D00000X, 208000000X, 208M00000X
NC2013-00639208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0069PTOtherBCBS
TX8W0343OtherBCBS
TX175588603Medicaid
TX175588604Medicaid
TX175588604Medicaid
TX8W0343OtherBCBS
NCNCD725AMedicare PIN
TX0069PTOtherBCBS