Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | Q0270 | TX |
NPI | 1013269455 |
---|---|
Provider Name | Dr. Cynthia Lynn Hartman |
First Address | Decatur, TX 76234-6156 |
Second Address | Decatur, TX 76234-3858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2012 |
Last Update Date | 18/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
338726801 | (05) | TX |
8EM909 | BCBS (01) | TX |