Healthcare Provider Details

I. General information

NPI: 1922035542
Provider Name (Legal Business Name): CYNTHIA J. THORNTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LITTLE SPURS PEDIATRIC URGENT CARE 11398 BANDERA RD. SUITE 201
SAN ANTONIO TX
78250
US

IV. Provider business mailing address

6 MCFADDIN
SAN ANTONIO TX
78261-2320
US

V. Phone/Fax

Practice location:
  • Phone: 210-543-7334
  • Fax:
Mailing address:
  • Phone: 210-543-7334
  • Fax: 210-543-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG9231
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: