Provider Demographics
NPI:1396978532
Name:KIEU, CYNTHIA TRAN (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:TRAN
Last Name:KIEU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:281-249-7100
Mailing Address - Fax:281-249-7365
Practice Address - Street 1:14703 EAGLE VISTA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5394
Practice Address - Country:US
Practice Address - Phone:281-249-7100
Practice Address - Fax:281-249-7365
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX887794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01599727OtherRR MEDICARE
TXP01599727OtherRR MEDICARE