Cynthia Lauren Dethlefs, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07149 Issued in TX

Practice address

8080 State Highway 121
Suite 210
McKinney, TX 75070-2900

Phone

(972) 268-9383

Fax

(972) 870-4925

NPI assigned

Feb 16, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Cynthia Lauren Dethlefs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1396042073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 STATE HIGHWAY 121",
            "address_2": "SUITE 210",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702900",
            "telephone_number": "972-268-9383",
            "fax_number": "972-870-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 STATE HIGHWAY 121",
            "address_2": "SUITE 210",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702900",
            "telephone_number": "972-268-9383",
            "fax_number": "972-870-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHLEFS",
        "first_name": "CYNTHIA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "DETHLEFS",
            "middle_name": "LAUREN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ravina Desai, OTD, OTR/L
• Shannon L Deshazo, M.D.
• Haley Elizabeth Desimone, PA-C
• Destefano Transitions MHT LLC
• Destiny Home Health LLC
• Allison Detloff
• Scott A Devilleneuve, M.D.
• Shala Devlin, PHARMD, RPH
• John M Devore, DC
• Dewayne Smith

• Physician Assistant in McKinney, TX
• Providers in McKinney, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.