Provider Demographics
NPI:1437983012
Name:CYNTHIA WHITEHEAD LLC
Entity type:Organization
Organization Name:CYNTHIA WHITEHEAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:696-252-5004
Mailing Address - Street 1:2609 COURTSIDE LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3851
Mailing Address - Country:US
Mailing Address - Phone:512-923-1293
Mailing Address - Fax:
Practice Address - Street 1:2719 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-4917
Practice Address - Country:US
Practice Address - Phone:469-625-2500
Practice Address - Fax:469-545-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty