Individual
CYNTHIA A LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
923 ROSEMOOR DR, ALLEN, TX 75013-5374
(817) 427-9014
Mailing address
923 ROSEMOOR DR, ALLEN, TX 75013-5374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K4131
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158932701
—
TX
01
—
DT4457
MEDICARE RAILROAD GROUP PTAN
TX
01
—
P01657830
MEDICARE RAILROAD PTAN
TX
Enumeration date
05/15/2006
Last updated
07/08/2019
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