Provider Demographics
NPI:1750358065
Name:SWAYZE SMITH, CYNTHIA (DO)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:SWAYZE SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN BLD C
Mailing Address - Street 2:A-94 PMB 138
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:214-828-6373
Mailing Address - Fax:214-828-6389
Practice Address - Street 1:7777 FOREST LN BLD C
Practice Address - Street 2:A-94 PMB 138
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:214-828-6373
Practice Address - Fax:214-828-6389
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4741207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H65500Medicare UPIN
8B5084Medicare ID - Type Unspecified