Provider Demographics
NPI:1447344387
Name:ENGELKING, CYNTHIA W (PA-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:W
Last Name:ENGELKING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 W PANTHER CREEK DR
Mailing Address - Street 2:STE 108
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3527
Mailing Address - Country:US
Mailing Address - Phone:281-364-8130
Mailing Address - Fax:832-381-2912
Practice Address - Street 1:4840 W PANTHER CREEK DR
Practice Address - Street 2:STE 108
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3527
Practice Address - Country:US
Practice Address - Phone:281-364-8130
Practice Address - Fax:832-381-2912
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01046363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89N227OtherBCBS
TX89N227OtherBCBS
TX86N148Medicare PIN