Individual
CINDY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 BOGOTA ST, ATHENS, TX 75752-8993
(979) 571-5503
Mailing address
3315 BOGOTA ST, ATHENS, TX 75752-8993
(979) 571-5503
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
333303
TX
Other
Enumeration date
04/27/2019
Last updated
04/27/2019
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