Healthcare Provider Details

I. General information

NPI: 1003441247
Provider Name (Legal Business Name): CYNTHIA ANN PLOTTS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W HOPKINS ST STE 102C
SAN MARCOS TX
78666-5749
US

IV. Provider business mailing address

604 APPALOOSA DR
FISCHER TX
78623-1801
US

V. Phone/Fax

Practice location:
  • Phone: 512-781-9246
  • Fax: 512-852-4736
Mailing address:
  • Phone: 512-565-7115
  • Fax: 512-852-4736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number23618
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: