Provider Demographics
NPI:1427092154
Name:CARSON, CYNTHIA G (PT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:G
Last Name:CARSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4455 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 50
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5101
Mailing Address - Country:US
Mailing Address - Phone:361-225-3492
Mailing Address - Fax:361-225-3617
Practice Address - Street 1:4455 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 50
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5101
Practice Address - Country:US
Practice Address - Phone:361-225-3492
Practice Address - Fax:361-225-3617
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist