Provider Demographics
NPI:1316048275
Name:GUINN, CYNDA PATTON (MS/RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:CYNDA
Middle Name:PATTON
Last Name:GUINN
Suffix:
Gender:F
Credentials:MS/RD, CDE
Other - Prefix:MRS
Other - First Name:CYNDI
Other - Middle Name:PATTON
Other - Last Name:GUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS/RD, CDE
Mailing Address - Street 1:7125 SANGER AVENUE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-4053
Mailing Address - Country:US
Mailing Address - Phone:254-399-5400
Mailing Address - Fax:254-399-5449
Practice Address - Street 1:7125 SANGER AVENUE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-4053
Practice Address - Country:US
Practice Address - Phone:254-399-5400
Practice Address - Fax:254-399-5449
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07188133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ17661Medicare UPIN
TX610697Medicare ID - Type Unspecified