MEDICARE: CYNTHIA S THORNTON OT

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	225X00000X	Occupational Therapist	107342	TX

General Provider Information

NPI Number	:	1710656897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA S THORNTON OT

Provider Business Mailing Address
First Line	:	PO BOX 30
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77522-0030
Country	:	US
Telephone Number	:	281-420-4520
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 N ALEXANDER DR
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77520-3368
Country	:	US
Telephone Number	:	281-420-4520
Fax Number	:

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

Provider Enumeration Date	:	09/10/2021
Last Update Date	:	09/10/2021

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