MEDICARE: CYNTHIA WATERS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	AP139445	TX

General Provider Information

NPI Number	:	1689141087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA WATERS NP

Provider Business Mailing Address
First Line	:	2701 MATLOCK RD STE 103
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2529
Country	:	US
Telephone Number	:	817-795-8346
Fax Number	:	817-717-1840

Provider Business Practice Location Address
First Line	:	2701 MATLOCK RD STE 103
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2529
Country	:	US
Telephone Number	:	817-795-8346
Fax Number	:	817-717-1840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	05/16/2023

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