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General NPI Number Information
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NPI Number | 1912320763
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Entity Type | Individual
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Provider Name | CYNTHIA POKLUDA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 900 CONGRESS AVE
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City | AUSTIN
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State | TX
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Zip | 78701-2437
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Country | US
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Telephone | 512-881-2515
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 149104
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City | AUSTIN
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State | TX
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Zip | 78714-9104
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Country | US
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Telephone | 512-881-2515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085.004861
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10944
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License Number State | TX
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