MEDICARE: MRS. CYNTHIA SILVAS BRUN LCSW

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	1041C0700X	Clinical Social Worker	40694	TX

General Provider Information

NPI Number	:	1871737049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA SILVAS BRUN LCSW

Provider Business Mailing Address
First Line	:	6297 RUDY VIDOVIC
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1855
Country	:	US
Telephone Number	:	915-731-2244
Fax Number	:

Provider Business Practice Location Address
First Line	:	6297 RUDY VIDOVIC
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1855
Country	:	US
Telephone Number	:	915-731-2244
Fax Number	:

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

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	04/30/2009

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