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General NPI Number Information
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NPI Number | 1689914434
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Entity Type | Organization
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Legal Business Name | CYNTHIA E. LARSON, D.O., P.A.
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Dates
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Enumeration Date | 02/14/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 3070 COLLEGE ST 207
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City | BEAUMONT
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State | TX
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Zip | 77701-4691
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Country | US
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Telephone | 409-833-5790
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Fax | 409-833-5899
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Provider Business Mailing Address
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Address Line | 3070 COLLEGE ST 207
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City | BEAUMONT
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State | TX
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Zip | 77701-4691
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Country | US
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Telephone | 409-833-5790
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Fax | 409-833-5899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CYNTHIA E. LARSON
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Credential | D.O.
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Telephone | 409-833-5790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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