Provider Demographics
NPI:1538723408
Name:BUENO, CYNTHIA MARIANNE (PA-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIANNE
Last Name:BUENO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 W MILE 10 RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-1899
Mailing Address - Country:US
Mailing Address - Phone:956-445-6333
Mailing Address - Fax:
Practice Address - Street 1:5201 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2708
Practice Address - Country:US
Practice Address - Phone:956-631-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA12755363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant