Provider Demographics
NPI:1770702540
Name:CLEMENTE, CYNTHIA ABAINZA (LPT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ABAINZA
Last Name:CLEMENTE
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5151 KATY FWY
Mailing Address - Street 2:SUITE305
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2260
Mailing Address - Country:US
Mailing Address - Phone:713-880-9500
Mailing Address - Fax:713-880-2434
Practice Address - Street 1:9894 BISSONNET ST
Practice Address - Street 2:SUITE 175
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8239
Practice Address - Country:US
Practice Address - Phone:713-779-4772
Practice Address - Fax:713-779-0551
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1041275174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist